Abstract: Objective To explore the diagnostic value of multi-slice spiral CT (MSCT) and MRI in abdominal wall involvement in patients with severe acute pancreatitis (SAP).
Methods The clinical data of 78 patients with SAP diagnosed and treated in the hospital between January 2018 and December 2019 were collected.All patients completed MSCT and MRI examinations.With pathological results as the golden standard,the diagnostic value of MSCT and MRI examinations in SAP abdominal wall involvement was evaluated.The MSCT and MRI findings of SAP abdominal wall involvement were observed.The detection rates of the location and depth of SAP abdominal wall involvement by MSCT and MRI were compared.
Results The accuracy and sensitivity of MSCT for diagnosis of abdominal wall involvement in patients with SAP were 87.18% (68/78) and 88.57% (31/35).The accuracy and sensitivity of MRI were 91.03% (71/78) and 94.29% (33/35).The detection rate of the location of abdominal wall involvement in patients with SAP by MRI [91.43 (32/35)] was higher than that by MSCT [80.00% (28/35)] (χ2=1.867,P>0.05).The detection rate of the depth of abdominal wall involvement in patients with SAP by MRI [94.29% (33/35)] was significantly higher than that by MSCT [77.14% (27/35)] (χ2=4.200,P<0.05).The MSCT findings of abdominal wall involvement in patients with SAP included increased density of subcutaneous fat in the abdominal wall,strip-shaped shadows,unclear boundary between the abdominal wall and the muscle,significantly thickened fat at the abdominal wall muscle and signals lower than the density of the same layer of muscle tissue.MRI scan showed that the fat layer on the abdominal wall showed slightly low signals on T1WI and T2WI fat suppression sequence high signal,increased muscle-muscle gap density and unclear boundaries.Muscle tissue showed spot-like,strip-like slightly low and irregular high-signal shadows.
Conclusion The diagnostic value of both MSCT and MRI are high in SAP patients with abdominal wall involvement,but the evaluation value of MRI for the location〖LM〗 and depth of SAP abdominal wall involvement is slightly higher than that of MSCT.

Key words: acute pancreatitis, severe, abdominal wall involvement, multi-slice spiral CT, magnetic resonance imaging