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摘要: [目的]研究急性胰腺炎（Acute pancreatitis，AP）胰周积液向纵隔扩散的MR表现及解剖基础，以及与急性胰腺炎MR严重指数（MR severity index，MRSI）的相关性。[方法]回顾分析69例因AP入院并进行MR检查患者。观察分析胰周积液向纵隔扩散的解剖途径并进行分级；AP的严重程度用MRSI评分分级并统计分析胰周积液与MRSI评分相关性。[结果]69例中，88.40%患者有不同程度胰周积液。胰周积液向纵隔扩散时食管裂孔受累31.14%，主动脉裂孔8.05%，下腔静脉裂孔3.25%。胰周积液评分与MRSI正相关（r=0.449，P<0.01）。[结论]AP伴发胰周积液较常见，胰周积液通过膈肌裂孔向纵隔扩散。胰周积液也可以作为评价AP严重程度的辅助指标。Abstract: [Objective] To study the anatomical basis and MR imaging of the peripancreatic effusion in the acute pancreatitis (AP) to the spread of mediastinum.[Methods] 69 patients with AP admitted to our institution, who underwent MR imaging after admission, were included in this study. The anatomical pathway of peripancreatic effusion to mediastinal spread, the effusion score and the MR severity index(MRSI) score of acute pancreatitis were analyzed and evaluated. The correlations between peripancreatic effusion grading and the MRSI score was analyzed by Spearman rank correlation tests. [Results] 88.40% of 69 patients with AP had different degrees of peripancreatic effusion visible on MRI. The anatomic pathways of peripancreatic effusion spreading to mediastinum included esophageal hiatus in 31.14% of all AP patients, aortic hiatusin 8.05%, and inferior vena cava hiatus in 3.25%.The grading of peripancreatic effusion on MRI showed a positive correlation with the MRSI scores(r=0.449, P=0.000). [Conclusion] Peripancreatic effusionin acute pancreatitison MRI is common, and peripancreatic effusion could spread to mediastinum, possibly through the diaphragmatic muscle hiatus. Moreover, peripancreatic effusion might be used as a supplementary indicator in evaluating the severity of AP.
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Key words:
- acute pancreatitis /
- peripancreatic effusion /
- anatomical pathways
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