CAJ | 학술논문

目的：探讨多层螺旋 CT(MSCT)对重症急性胰腺炎(SAP)并发急性门静脉系统血栓的诊断价值，以提高对本病的认识。方法对45例已确诊的 SAP 并发急性门静脉系统血栓患者的临床和影像学资料进行回顾性分析。结果45例患者均有急性上腹部疼痛。血栓平均检出时间为26 d。平扫血栓表现为稍高或等密度影并血栓所在部位血管管腔稍扩张；增强扫描血栓表现为斑点状、结节状或条柱状充盈缺损，完全闭塞则表现为“火车轨道”样改变。结论MSCT 平扫、增强扫描以及三维重建技术能对 SAP合并急性门静脉系统血栓作出明确诊断。
목적：탐토다층라선 CT(MSCT)대중증급성이선염(SAP)병발급성문정맥계통혈전적진단개치，이제고대본병적인식。방법대45례이학진적 SAP 병발급성문정맥계통혈전환자적림상화영상학자료진행회고성분석。결과45례환자균유급성상복부동통。혈전평균검출시간위26 d。평소혈전표현위초고혹등밀도영병혈전소재부위혈관관강초확장；증강소묘혈전표현위반점상、결절상혹조주상충영결손，완전폐새칙표현위“화차궤도”양개변。결론MSCT 평소、증강소묘이급삼유중건기술능대 SAP합병급성문정맥계통혈전작출명학진단。
Objective To evaluate the value of multi-slice spiral CT(MSCT)in diagnosing severe acute pancreatitis accompanied by thrombosis in portal venous system in order to improve the recognition of the disease.Methods 45 patients with severe acute pan-creatitis accompanied by thrombosis in portal venous system confirmed by clinical data and MSCT findings were analyzed retrospec-tively.Results All 45 patients had acute up-abdominal pain.The mean detection time of thrombosis was 26 days.Thromboses were slightly higher density to iso-density in plain scan and slightly vasodilatation where thrombosis was located,showed mottling,nodu-lar or strip filling defect in enhanced scan and total occlusion was usually confined to train tract sign.Conclusion Severe acute pan-creatitis accompanied by portal venous system thrombosis can be found by plain and enhanced multi-slice spiral CT scan in combina-tion with 3D reconstruction.