Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue
Authors: Lv Xinjian , Zhou Haifeng , Ding Conghua , Zhang Ni 
Published: November 2023

Abstract
Objective: Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue.
Methods: 97 patients with suspected severe pancreatitis who were examined in our hospital and inpatient department between July 2019 and July 2021 were selected as the study subjects. All patients underwent multilayer spiral CT enhancement and ultrasound scans in a stable condition. The pictorial characteristics of multi-slice spiral CT enhancement and ultrasound scan in two groups of patients with acute severe pancreatitis were observed and recorded, the diagnostic value of multi-slice spiral CT enhanced scan and combined ultrasound diagnosis of acute severe pancreatitis and pathological examination results, and the diagnostic value of multi-slice spiral CT enhanced scan and joint ultrasound for the diagnosis of acute severe pancreatitis.
Results: Multi-layer spiral CT (MSCT) enhanced scan showed local or diffuse cell enlargement of the pancreas and inflammatory cell changes in the peripaniatic fat connective tissue. Inflammatory changes in the peripaniatic adipate connective tissue, intra-parenchymal or peripancreatic effusion of the pancreas, including pancreatic and fat necrosis, pancreatic abscesses. Different degrees of localized or diffuse weak or no reinforced low-density necrosis areas are visible in the parenchyma of the pancreas. The pancreas is significantly enlarged, especially in the tail of the pancreas, and a small amount of exudation is seen around the pancreas; ultrasound image features: the echo of the pancreas parenchyma is uniform or unevenly weakened, manifested by edema or hemorrhagic necrosis. Clinical examination of the lesion confirmed that 61 patients were affected with Severe acute pancreatitis(SAP), and 33 cases were negative patients. Taking the pathological examination results as the gold standard, 65 patients were diagnosed with multi-slice spiral CT enhanced scan and 60 cases were diagnosed with joint diagnosis; the sensitivity of joint detection (93.44%) was significantly higher than that of multilayer spiral CT enhanced scan (88.52%); the specificity of joint detection (90.91%) was higher than that of multilayer spiral CT enhanced scan (78.79%); and the accuracy of joint detection (92.55%) was higher than that of multilayer spiral CT enhanced scan (85.11%). The diagnostic value of contrast-enhanced ultrasound (CEUS) combined with multi-slice helical CT (MSCT) for tongue cancer and its lymph node metastasis (LNM) has also been assessed.
Conclusion: Multi-layer spiral CT enhanced scanning combined with ultrasonography can help diagnose in patients with diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue., improve accuracy, sensitivity and specificity, and then improve the clinical diagnostic value.