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超越修订后的亚特兰大分类:急性胰腺炎及其并发症影像评估的全面综述

Beyond the revised atlanta classification: a comprehensive review of the imaging assessment of acute pancreatitis and its complications.

作者信息

Chagas Lucia Antunes, Albuquerque Kamila Seidel, Soares Luciana Eltz, Machado Dequitier Carvalho, De Moraes Antunes Paulo, Stern João Jabour, Dos Santos Romão Davi, Morais E Rodrigues da Cunha Fonseca Beatriz, Horvat Natally

机构信息

Department of Radiology, Hospital Samaritano Higienópolis, Rua Conselheiro Brotero, 1486 - Higienópolis, São Paulo, SP, 01232010, Brazil.

Department of Radiology, Cardiology Institute - Fundação Universitária de Cardiologia (ICFUC), 395 Av. Princesa Isabel, Porto Alegre, RS, Brazil.

出版信息

Abdom Radiol (NY). 2025 Jan;50(1):423-437. doi: 10.1007/s00261-024-04425-2. Epub 2024 Jul 2.

Abstract

While the Revised Atlanta Classification outlines the primary complications of acute pancreatitis, it is crucial to recognize additional factors that contribute to morbidity and mortality associated with acute pancreatitis. In this review, we discuss the imaging-based classification and staging of acute pancreatitis as described by the Revised Atlanta Classification, but also provide a comprehensive understanding of the pancreatic anatomy and its relation to surrounding structures, which is essential for imaging-based assessment of both acute pancreatitis and its complications. We further extend the discussion beyond common complications such as pseudocysts and walled-off necrosis to include lesser-known but significant complications such as peripancreatic infection, disconnected ductal disconnection syndrome, thrombosis, hemorrhage, and gastrointestinal complications. Additionally, illustrative examples are presented to highlight relevant points pertaining to real-life imaging assessment of acute pancreatitis and its complications.

摘要

虽然《亚特兰大分类修订版》概述了急性胰腺炎的主要并发症,但认识到导致急性胰腺炎相关发病率和死亡率的其他因素至关重要。在本综述中,我们讨论了《亚特兰大分类修订版》所描述的基于影像学的急性胰腺炎分类和分期,同时还全面介绍了胰腺解剖结构及其与周围结构的关系,这对于基于影像学评估急性胰腺炎及其并发症至关重要。我们进一步将讨论范围扩展到假性囊肿和包裹性坏死等常见并发症之外,包括胰腺周围感染、导管离断综合征、血栓形成、出血和胃肠道并发症等鲜为人知但很重要的并发症。此外,还给出了示例,以突出与急性胰腺炎及其并发症的实际影像学评估相关的要点。

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