Ultrasound imaging in the evaluation of severe acute pancreatitis / 中国医师杂志

ABSTRACT

Objective:To explore the clinical value of color doppler ultrasound (CDFI) in the diagnosis of severe pancreatitis.Methods:150 patients with acute pancreatitis (AP) admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2014 to January 2018 were selected according to the " 2013 Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China" . Among them, 95 patients with common AP (mild group) and 55 patients with severe AP (severe group). The CDFI ultrasound imaging characteristics of the two groups were compared, and the relationship between the ultrasound score of pancreatitis and acute physiological function and chronic health score (APACHE Ⅱ) was analyzed.Results:The incidence of diffuse pancreatic enlargement (61.82%), blurred pancreatic contour (72.73%), lamellar hypoechoic pancreatic parenchyma (47.27%), thickening of omental sac (25.45%), peripancreatic effusion (60.00%) in severe group was higher than that in mild acute pancreatitis (17.89%, 43.16%, 13.68%, 7.37%, 14.74%), with statistically significant difference ( P<0.05). In the severe group, the ultrasound score (7.35±1.52) and the APACHE Ⅱ score (18.7±5.5) were higher than those with mild acute pancreatitis (4.41±1.33, 6.2±1.5), and the difference was statistically significant ( P<0.05); there was a significant positive correlation between the ultrasound score and the APACHE Ⅱ score in the severe group ( r=0.669, P<0.01). The sensitivity, specificity, missed diagnosis rate and misdiagnosis rate were 83.64%, 74.74%, 16.36% and 25.26% respectively. Conclusions:As a non-invasive and rapid diagnosis method, CDFI has certain clinical practical value in the identification of patients with acute pancreatitis.