Practical imaging in acute pancreatitis.

Seminars in gastrointestinal disease Pub Date : 1998-04-01
D E Morgan, T H Baron
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Abstract

Pancreatitis may be acute or chronic, mild or severe. In patients with acute pancreatitis the optimal imaging test is dynamic intravenous and oral contrast enhanced computed tomography (CECT). Serial CECTs are useful to monitor disease progression and to assess intraabdominal complications in patients with severe acute pancreatitis. CECT is helpful in planning the approach (endoscopic transmural versus percutaneous) for pancreatic drainage. Computed tomography or ultrasound-guided aspiration of pancreatic collections is safe, sensitive, and specific and has become a routine procedure used to screen for infected necrosis. When pancreatic drainage is contemplated, magnetic resonance imaging is useful for identifying residual necrotic debris within the collection. Patients with mild acute pancreatitis usually require no cross-sectional imaging study other than ultrasound screening for gallstones, if gallstone pancreatitis is suspected clinically. In patients with chronic pancreatitis, screening for complications such as superimposed acute pancreatitis or development of pancreatic pseudocysts may be performed with CECT or ultrasound.

急性胰腺炎的实用影像学。
胰腺炎可分为急性或慢性,轻度或重度。急性胰腺炎患者的最佳影像学检查是动态静脉和口服对比增强计算机断层扫描(CECT)。连续cct可用于监测重症急性胰腺炎患者的疾病进展和评估腹腔内并发症。CECT有助于规划胰引流入路(内镜下经壁或经皮)。计算机断层扫描或超声引导下的胰腺穿刺安全、灵敏、特异,已成为筛查感染性坏死的常规方法。当考虑胰腺引流时,磁共振成像可用于识别收集物中残留的坏死碎片。如果临床上怀疑胆结石性胰腺炎,轻度急性胰腺炎患者通常不需要进行横断面成像检查,只需进行胆结石超声筛查即可。对于慢性胰腺炎患者,可以用CECT或超声筛查并发症,如叠加性急性胰腺炎或胰腺假性囊肿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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