Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
Abdom Radiol (NY). 2020 May;45(5):1350-1358. doi: 10.1007/s00261-020-02473-y.
The amount of intra-abdominal fat on CT correlates positively with the severity of acute pancreatitis (AP). The objective of the study was to evaluate a fat-modified CT severity index (FMCTSI) and compare its performance with MCTSI.
For this retrospective study, 99 patients with AP who underwent contrast-enhanced CT between 3 and 7 days after pain onset were divided into a training cohort (n = 75) and a validation cohort (n = 24). MCTSI was calculated. The total adipose tissue (TAT), visceral adipose tissue (VAT), and total to visceral fat ratio (TVFR) were computed using semi-automatic software. These parameters were given a score of 1-3. FMCTSI was calculated by adding the fat score to MCTSI. Concordance for diagnosing the severity of AP was assessed. Areas under receiver operating characteristic curves (AUC) for predicting clinical outcomes were compared between FMCTSI and MCTSI. The diagnostic performance of the FMCTSI in the validation cohort was also evaluated.
In the training cohort, our proposed FMCTSI performed better than MCTSI for all the outcome parameters. The highest concordance for the severity of AP was achieved for VAT-MCTSI. For all outcome parameters, the highest AUC was seen for TVFR-MCTSI. In the validation cohort, the FMCTSI achieved diagnostic performance similar to the training cohort with the highest AUC for TVFR-MCTSI.
FMCTSI is a better CT index than MCTSI for predicting the severity and clinical outcomes of AP. Among the various FMCTSI parameters, TVFR-MCTSI is the best performer.
CT 扫描显示的腹腔内脂肪量与急性胰腺炎（AP）的严重程度呈正相关。本研究旨在评估脂肪改良 CT 严重指数（FMCTSI）并与 MCTSI 进行比较。
这项回顾性研究纳入了 99 例在发病后 3-7 天内接受增强 CT 检查的 AP 患者，将其分为训练队列（n=75）和验证队列（n=24）。计算 MCTSI。使用半自动软件计算总脂肪组织（TAT）、内脏脂肪组织（VAT）和总脂肪到内脏脂肪比（TVFR）。这些参数的评分为 1-3 分。FMCTSI 通过将脂肪评分添加到 MCTSI 来计算。评估诊断 AP 严重程度的一致性。比较 FMCTSI 和 MCTSI 预测临床结局的受试者工作特征曲线下面积（AUC）。还评估了 FMCTSI 在验证队列中的诊断性能。
在训练队列中，我们提出的 FMCTSI 在所有结局参数方面均优于 MCTSI。对于 AP 的严重程度，VAT-MCTSI 的一致性最高。对于所有结局参数，TVFR-MCTSI 的 AUC 最高。在验证队列中，FMCTSI 与训练队列的诊断性能相似，TVFR-MCTSI 的 AUC 最高。
FMCTSI 是预测 AP 严重程度和临床结局的比 MCTSI 更好的 CT 指数。在各种 FMCTSI 参数中，TVFR-MCTSI 的性能最佳。
