Kumar P, Mukhopadhyay S, Sandhu M, Berry M
Department of Radio Diagnosis, All India Institute of Medical Sciences, New Delhi.
Australas Radiol. 1995 May;39(2):145-52. doi: 10.1111/j.1440-1673.1995.tb00259.x.
Fifty-seven patients (45 males, 12 females) with a clinical diagnosis of acute pancreatitis were serially evaluated by ultrasonography (US) and computed tomography (CT). Thirty patients had a single study, 18 had one follow-up study while 9 had two follow-up studies. The aetiology was gallstone disease in 26% of patients and a history of chronic alcohol abuse in only 16%. No cause could be identified in 47% of patients; 22% of US scans were unsatisfactory for the evaluation of pancreas whereas CT was uniformly satisfactory. Peripancreatic inflammation was detected in only 29% patients on US compared with 91% on CT. Pancreatic abscesses were detected in 8 patients on CT and gas was present in all of them. Fourteen patients underwent guided interventional procedures (US, 12; CT, 2). On follow up after 3 months, worsening of inflammation was detected in 11% patients on CT, which was not detected on US. It is concluded from this study that CT is far superior to US in the evaluation of acute pancreatitis, detection of peripancreatic inflammation and its extension into the retroperitoneal compartments and mesentery, and also for the evaluation of fluid collections, haemorrhage and abscesses. However, US provides easy guidance for percutaneous interventional procedures and can be used for follow-up scans.
57例临床诊断为急性胰腺炎的患者（45例男性，12例女性）接受了超声检查（US）和计算机断层扫描（CT）的系列评估。30例患者仅进行了一次检查，18例进行了一次随访检查，9例进行了两次随访检查。病因方面，26%的患者为胆石症，仅有16%的患者有慢性酒精滥用史。47%的患者无法明确病因；22%的超声扫描对胰腺评估不满意，而CT评估均令人满意。超声检查仅发现29%的患者有胰腺周围炎症，而CT检查发现91%的患者有该炎症。CT检查发现8例患者有胰腺脓肿，且所有患者均有气体存在。14例患者接受了引导介入操作（超声引导12例，CT引导2例）。在3个月的随访中，CT检查发现11%的患者炎症加重，超声检查未发现这一情况。该研究得出结论，在评估急性胰腺炎、检测胰腺周围炎症及其向腹膜后间隙和肠系膜的蔓延，以及评估液体积聚、出血和脓肿方面，CT远比超声优越。然而，超声为经皮介入操作提供了便捷的引导，可用于随访扫描。
