| Objective: Through the collection, analysis of severe acute pancreatitis local complication of abdominal wall CT, MRI plain scan and enhancement, and to observe the correlation between the severity of pancreatitis and the complication of abdominal wall, in order to make a more comprehensive imaging diagnosis of severe acute pancreatitis, detailed information, provide the index of severity of acute pancreatitis is more perfect for the clinic, so as to guide the clinical treatment and prognosis judgment. Methods: In strict accordance with the inclusion and exclusion criteria, were collected retrospectively in our hospital from 2009 October to 2014 December, underwent CT, MR examination before the clinical suspicion of "acute pancreatitis", in 1 weeks in our hospital underwent abdominal CT and(or) MR, good CT, abdominal plain MR scan and enhanced scan(or). The image quality of 130 cases of abdominal wall were observed, according to the scope of evaluate the severity of pancreatitis and pancreatic necrosis scores, statistics of abdominal wall affected parts, abnormal manifestations and observe the affected area distribution, involving the depth and CT, MR expression, The incidence of abnormal changes in calculation of the abdominal wall, and using the CT severity index(CT, severity index, CTSI MR severity index(MR) and severity index, MRSI) the patients according to the scope of necrosis of pancreas were classified, analyzed the correlation between severity of pancreatitis and the change rate of abdominal wall, and selected 4 cases of patients with in the first 30 minutes after CT and MR scan, CT and MR showed that the observed difference in sensitivity of abdominal wall were compared, and the involvement of range size.Results: In this group of cases 56 cases reached the standard of severe acute pancreatitis, a total of 48 cases(85.71%) with abdominal wall involvement, in which CT was found in 21 patients, MR was found in 27 cases. Abdominal wall changes occurred mainly in the lateral abdominal wall, especially in the left side of the abdominal wall.(47.91%), in some cases can forward diffusion to the anterior abdominal wall and even more involved the left side abdominal midline abdominal wall, the majority of cases can be found in the area of abnormal waist and back subcutaneous clearance rate was 60.41%. The main CT abdominal wall involvement in the abdominal wall fat space density change with uneven thickness, to more consistent line, strip abnormal density, abdominal wall muscle swelling, muscle gap fuzzy not clear, the affected muscle density is lower than the same level of involvement in abdominal wall muscle density, the area of subcutaneous circuitous curve strip slightly low density when the back is changed; MR mainly manifested as abdominal wall soft tissue signal mixed uneven, irregular, uneven slightly low T1 WI and high T2 WI signal, multiple patchy, line shape, strip shape is the main morphological characteristics of abnormal signal, which go for similar lines, strip shadow seen, abdominal muscle the outline is not clear, the abdominal wall muscle gap is fuzzy, soft tissue swelling, waist and back subcutaneous significantly low T1 WI, high T2WI- curve abnormal signal strip; During CT, patients with MR scan, CT scan of 1 cases of abdominal wall density change in MR images in 4 cases showed abnormal signal of abdominal wall, abdominal wall and MR shows abnormal changes in the scope and depth of greater than CT is shown. CT scans of 1 cases of abdominal wall abscess, enhanced scan showed moderate ring like enhancement, no enhancement in the center. Conclusion: Abdominal wall changes and acute severe pancreatitis severity classification and clinical evaluation standard was positively related to relationship, prompt the C T, MR signs can to a certain extent, the seriousness of the reaction of severe acute pancreatitis. MR images of abdominal wall soft tissue involvement showed high sensitivity, should be widely used in clinical examination. |
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