Taydas Onur, Unal Emre, Karaosmanoglu Ali Devrim, Onur Mehmet Ruhi, Akpinar Erhan
School of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey.
Jpn J Radiol. 2018 Feb;36(2):151-158. doi: 10.1007/s11604-017-0709-9. Epub 2017 Nov 21.
To investigate whether computed tomography (CT)-based scoring systems obtained within 72 h of symptoms onset can predict disease course in acute pancreatitis.
Between October 2007 and December 2015, 189 patients (age range 21-93 years) who underwent abdominopelvic CT for the diagnosis of acute pancreatitis were included in the study. Balthazar grade and original and modified versions of CT severity index (CTSI) measurements were carried out for each patient.
There were significant associations between each CT based scoring system and development of pancreatic and extrapancreatic complications (p < 0.001). A cutoff value of > 6 for CTSI and > 9 for the modified version of CTSI achieved a specificity of 98.7 and 99.2% for predicting pancreatic and extrapancreatic complications with areas under the curve (AUC) of 0.96 and 0.96, respectively. Balthazar grade of > C yielded a sensitivity of 98.4% for predicting pancreatic and extrapancreatic complications with an AUC of 0.95. The modified version of CTSI had the most significant association with pancreatic and extrapancreatic complications (HR: 3.22; p = 0.002, HR: 2.99, p = 0.003, respectively). Pancreatic necrosis was the only parameter significantly associated with mortality (HR: 5.83, p = 0.045).
Early CT scan has an important role in prediction of complications and the management of acute pancreatitis.
探讨症状发作72小时内获得的基于计算机断层扫描（CT）的评分系统能否预测急性胰腺炎的病程。
2007年10月至2015年12月，189例因诊断急性胰腺炎接受腹盆腔CT检查的患者（年龄范围21 - 93岁）纳入本研究。对每位患者进行Balthazar分级以及CT严重指数（CTSI）原始版本和改良版本的测量。
每个基于CT的评分系统与胰腺及胰腺外并发症的发生之间存在显著关联（p < 0.001）。CTSI > 6以及CTSI改良版> 9的截断值在预测胰腺及胰腺外并发症时，特异性分别为98.7%和99.2%，曲线下面积（AUC）分别为0.96和0.96。Balthazar分级> C在预测胰腺及胰腺外并发症时敏感性为98.4%，AUC为0.95。CTSI改良版与胰腺及胰腺外并发症的关联最为显著（HR：3.22；p = 0.002，HR：2.99，p = 0.003）。胰腺坏死是与死亡率显著相关的唯一参数（HR：5.83，p = 0.045）。
早期CT扫描在预测并发症及急性胰腺炎的管理中具有重要作用。
