目的

探讨CT 检查与彩色多普勒超声检查对急性胰腺炎合并脂肪肝患者的诊断价值。

方法

回顾性分析2021 年5 月至2023 年7 月在仪陇县人民医院诊治的100 例急性胰腺炎患者的临床和影像学资料，所有患者均接受CT 和彩色多普勒超声检查，分析两种检测方法对急性胰腺炎的影像学特征和对脂肪肝的检出情况，并采用Kappa 分析急性胰腺炎患者的CT 和彩超诊断合并脂肪肝情况。

结果

100 例急性胰腺炎患者中合并脂肪肝67 例，未合并脂肪肝33 例。CT 显示，91例（91.00%）患者表现为胰腺CT 体积增大，86 例（86.00%）密度减低，40 例（40.00%）肝脏CT密度减低，其中19 例（47.50%）弥漫性减低、21 例（52.50%）局限性减低。超声显示，胰腺表现出不同程度增大，其中边缘模糊、回声减低48 例（48.00%），轮廓不清、回声不均52 例（52.00%）；肝内血管不明显、强回声32 例（32.00%），肝脏超声质地不均18 例（18.00%）。CT 检测急性胰腺炎合并脂肪肝患者40 例，Kappa 一致性为0.650，超声检测急性胰腺炎合并脂肪肝患者50 例，Kappa一致性为0.520。CT 诊断合并脂肪肝准确度、敏感度和特异度分别为65.00%、59.70%和75.80%，超声诊断合并脂肪肝准确度、敏感度和特异度分别为77.00%、74.60%和81.80%，差异均无统计学意义（P＞0.05）。

结论

急性胰腺炎患者采用CT 与彩色多普勒超声诊断差异不大，均对合并脂肪肝具有较高的诊断价值。

Objective

To explore the diagnostic value of CT and ultrasound in acute pancreatitis patients complicated with fatty liver.

Methods

A retrospective analysis was performed on clinical and imaging data of 100 patients with acute pancreatitis in Yilong County People's Hospital between May 2021 and July 2023. All patients underwent CT and color Doppler ultrasound examinations. The imaging characteristics of acute pancreatitis and the detection of fatty liver of the two detection methods were analyzed.The detection of fatty liver by CT and color ultrasound was analyzed by Kappa analysis.

Results

Among 100 patients with acute pancreatitis，there were 67 cases with fatty liver and 33 cases without. CT examination showed that there were 91 cases （91.00%） with increased CT volume of pancreas，86 cases （86.00%） with decreased density and 40 cases （40.00%） with decreased CT density of liver [including 19 cases （47.50%）with diffuse decrease and 21 cases （52.50%） with limited decrease]. The ultrasound examination showed that there was pancreas enlargement to different extent，including 48 cases （48.00%） with blurred edge and decreased echo，52 cases （52.00%） with blurred contour and uneven echo. There were 32 cases （32.00%）with non-obvious hepatic vessels and strong echo，and 18 cases （18.00%） with uneven ultrasonic texture of liver. CT showed that there were 40 cases with fatty liver，with Kappa consistency of 0.650. Color ultrasound showed that there were 50 cases with fatty liver，with Kappa consistency of 0.520. There were no statistically significant differences in accuracy，sensitivity and specificity between CT and color ultrasound in the diagnosis of fatty liver （65.00%，59.70%，75.80% vs 77.00%，74.60%，81.80%，P＞0.05）.

Conclusion

There is few difference between CT and color Doppler ultrasound in diagnosis of patients with acute pancreatitis，and both have high diagnostic value in fatty liver.