Onur Taydas1, Emre Unal2, Ali Devrim Karaosmanoglu2, Mehmet Ruhi Onur2, Erhan Akpinar2. 1. School of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey. taydasonur@gmail.com. 2. School of Medicine, Department of Radiology, Hacettepe University, 06100, Ankara, Turkey.
Abstract
PURPOSE: To investigate whether computed tomography (CT)-based scoring systems obtained within 72 h of symptoms onset can predict disease course in acute pancreatitis. METHODS: 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. RESULTS: 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). CONCLUSION: Early CT scan has an important role in prediction of complications and the management of acute pancreatitis.
PURPOSE: To investigate whether computed tomography (CT)-based scoring systems obtained within 72 h of symptoms onset can predict disease course in acute pancreatitis. METHODS: 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. RESULTS: 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). CONCLUSION: Early CT scan has an important role in prediction of complications and the management of acute pancreatitis.
Entities:
Keywords:
Acute pancreatitis; Complication; Computed tomography; Prognosis; Severity index
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