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目的:评价多种磁共振评分系统与急性生理年龄慢性健康评分系统Ⅱ预测急性胰腺炎严重程度的准确性。方法:临床确诊161例急性胰腺炎患者接受MRI检查(其中平扫86例,平扫+增强75例),对75例急性胰腺炎MRI增强患者,五种磁共振评分系统(Balthazar分级、磁共振严重指数、修正磁共振严重指数、胰外炎症磁共振评分、肠系膜水肿与腹膜腔积液评分)对其严重程度进行评价,对所有161例急性胰腺炎患者,三种磁共振评分系统(Balthazar分级、胰外炎症磁共振评分、肠系膜水肿与腹膜腔积液评分)对其严重程度进行评价。利用ROC曲线比较分析磁共振评分系统与急性生理年龄慢性健康评分系统Ⅱ预测急性胰腺炎严重程度的准确性。结果:161例急性胰腺炎患者,25例(15.5%)临床上确诊为重度急性胰腺炎,6例(3.7%)死亡。磁共振严重指数、胰外炎症磁共振评分预测急性胰腺炎严重程度及死亡具有较高的准确性,但磁共振评分系统与急性生理年龄慢性健康评分系统Ⅱ预测急性胰腺炎严重程度无显著差异(P>0.05)。结论:与急性生理、年龄、慢性健康评分系统Ⅱ比较,磁共振评分系统预测急性胰腺炎严重程度没有优势,急性胰腺炎入院接受MRI检查评价严重程度不被推荐。
PURPOSE: To evaluate the accuracy of multiple magnetic resonance scoring systems and the Acute Physiology Chronic Health Score System Ⅱ in predicting the severity of acute pancreatitis. Methods: One hundred and sixty-one patients with acute pancreatitis underwent MR examination (including 86 cases of plain scan and 75 cases of plain scan and enhancement). Five MRI scoring systems (Balthazar grading, magnetic resonance Severity index, modified magnetic resonance severity index, extrapancreatic inflammatory magnetic resonance score, mesenteric edema and peritoneal effusion score) were evaluated for severity in all 161 patients with acute pancreatitis. Three magnetic resonance scoring systems (Balthazar grading , Extra-pancreatic inflammatory magnetic resonance score, mesenteric edema and peritoneal effusion score) were evaluated for their severity. Using ROC curve comparative analysis of MR score system and AQR Ⅱ to predict the severity of acute pancreatitis. Results: 161 patients with acute pancreatitis, 25 patients (15.5%) clinically diagnosed as severe acute pancreatitis, 6 patients (3.7%) died. Severe Magnetic Resonance Index and Magnetic Resonance Score of Extra Pancreatitis Predict the severity of acute pancreatitis and death with high accuracy. However, the severity of acute pancreatitis was not significantly different between MRS and acute physiological age chronic health score system Ⅱ P> 0.05). Conclusion: Compared with acute physiology, age and chronic health scoring system Ⅱ, the scoring system predicts the severity of acute pancreatitis has no advantage. It is not recommended to evaluate the severity of acute pancreatitis by MRI.