消化模块－肝胆胰影像（二节课）《消化与营养模块》.pptVIP

4、胰腺的密度、边缘 Density and border: 密度：较肝、脾低，均匀或欠均匀， Density: lower than liver and spleen, even or uneven. 小叶间质及胰管 Nodular interstitial and pancreas duct 边缘：光整或呈锯齿状 Border: smooth or serrated 胰腺的大小、密度、边缘与年龄、肥瘦、 层厚有关 Size, density, border corresponds to age body figure CT thickness 2、急性出血坏死性胰腺炎Acute hemorrhagic necrotizing pancreatitis 1）胰腺明显弥漫性肿大；Significant diffuse pancreatic enlargement; 2）平扫及增强全胰密度很不均匀： Uneven pancreas-density 胰腺水肿---胰腺密度普遍减低； Pancreatic edema--generally lower density; 坏死区域---更低，斑片状，皂泡状； Necrosis —much lower, patchy, soap bubble 出血区域---密度升高； hemorrhagic area—density increase 3）胰周改变 轮廓模糊--消失； Peripancreatic change: contour fuzzy/disappeared; 4）胰外改变：脂肪坏死和积液 向前---小网膜囊积液； 向后---左前肾旁间隙积液； Extrapancreatic: lipo necrosis and effusion, toward—fluid effusion in lesser sac backward--anterior pararenal space 5）并发症 complication 胰内、胰周脓肿：增强见脓肿强化明显，脓液密度， Pancreas, parapancreatic abscess : Abscess enhances significantly, pus density 假性囊肿：积液未吸收、纤维粘连包裹，清楚或模糊，囊液密度多低而均匀， Pseudocyst: fluid not absorbed, fibrous adhesions and packages, clear or fuzzy cyst fluid is low density and more uniform 急性坏死性胰腺炎演变 Evolution of acute necrotizing pancreatitis 10/4 22/4 23/5 急性胰腺炎，评分 Acute pancreatitis, score 5月前 5 months ago 二、慢性胰腺炎 Chronic pancreatitis （一）病因和病理 半数与急性反复发作有关，其他； 腺体萎缩，纤维化，胰管扩张，钙化，假性囊肿， Etiology and pathology: Half of patients with recurrent attacks of acute pancreatitis, others; Gland atrophy, fibrosis, pancreatic duct dilatation, calcification, pseudocyst （二）临床表现 常较含糊 Clinical manifestation：Often more ambiguous （三）CT表现 有多项改变较易诊断，约1/5病例可阴性， CT manifestations: About 1 / 5 cases can be negative 1. 胰腺体积改变 pancreatic volume change （1）多数缩小，密度降低；单此表现者，需与老年性改变鉴别； most case volume reduce, density decrease,