[Correlation analysis of computed tomography imaging scoring to the presence of acute kidney injury in severe acute pancreatitis].

OBJECTIVE

To investigate the multi-detector-row spiral CT (MDCT) imaging findings of severe acute pancreatitis (SAP) complicated with acute kidney injury (AKI), and to evaluate the correlation of MDCT imaging scoring to the presence of AKI in SAP.

METHODS

One hundred and nineteen patients with confirmed diagnosis of SAP during March 2008-December 2010 in our hospital were retrospectively included into the study. The imaging features including pancreatic size, areas and degrees of pancreatic necrosis, peripancreatic retroperitoneal and intraperitoneal inflammation and other organs involvement (liver, kidney, spleen, gastrointestinal tract, etc.) were observed, as well as related CT severity indexes such as Balthazar CT score, CT severity index (CTSI) and extra-pancreatic inflammation on CT (EPIC) score were calculated. At the mean time, the clinical data including serum creatinine, urine output and the eventual prognosis were collected and compared with CT indexes, which was used for statistical analysis.

RESULTS

SAP with AKI patients were often associated with the high incidence of multiple organ dysfunction (MODS) (88.1%) and high mortality (47.6%). In SAP with AKI patients, the CT indexes were significantly higher than those of SAP without AKI patients. Among the CT indexes, EPIC score showed the larger area under the ROC curve (AUC = 0.903) than CTSI score (AUC = 0.721) and Balthazar CT score (AUC = 0.571).

CONCLUSION

Among the CT indexes, EPIC score has a better prediction of AKI in SAP patients than CTSI and Balthazar CT scores.