MSCT Perfusion Imaging of Pancreatic Microcirculatory Impairment in Acute Pancreatitis

Objective:To investigate the characteristics of microcirculatory impairment in acute pancreatitis and the value of MSCT perfusion imaging in clinical application.Methods:According to the clinical diagnostic criteria and Balthazar plain CT scan score,69 acute pancreatitis patients within 48 hours of hospitalization including 42 cases of mild acute pancreatitis (MAP,CT grade A=16,B=9,C=17) and 27 cases of severe acute pancreatitis (SAP,CT grade D=11,E=16) as well as 12 control patients taking chest CT but without pancreatic disease were recruited in the study.MSCT perfusion imaging of pancreas were performed for all patients.Those parameters of pancreatic perfusion,including time density curve (TDC),blood flow (BF),blood volume (BV),mean transit time (MTT) and surface permeability (PS) were measured.Results:The maximum ascend inclination rate and peak value of TDC of pancreas were lower in acute pancreatitis than that in controls.The pancreatic BV of the control group,MAP and SAP descent successively,significant statistical differences were existed (P0.05).Pancreatic BF,BV of SAP were significantly lower than that of MAP,yet MTT and PS were higher,with significant statistical difference (P0.05).The BF of MAP patients with CT grade A were higher than that in control group,yet the BF and BV in patients with CT grade B and C were lower and PS were higher than those in controls with significant statistical differences (P0.05).Conclusion:The patterns of pancreatic blood perfusion in acute pancreatitis were in close relationship with the severity.The trend was ascended firstly then declined.The degree of micro-circulation of pancreas could be quantitatively evaluated by MSCT perfusion imaging,which showed potential clinical value in the gradation of early acute pancreatitis.