Objective: To investigate the correlation between CT pancreatic inflammatory infiltration degree of severe acute pancreatitis (SAP) and the clinical disease severity, and to explore its prognostic value.
Methods: One hundred and nineteen (83) patients with confirmed diagnosis of SAP during 2008-2010 in West China Hospital of Sichuan University were retrospectively included into the study. Contrast-enhanced multi-detector-row CT (including dual source CT) scan was performed for all the patients. The abnormal imaging features, such as pancreatic and peri-pancreatic inflammatory changes, involvement of other organs and local complications, were observed and used to calculate several CT severity indexes. Also, the clinical data were collected and compared with CT severity indexes.
Results: The CT scores of SAP with local complications CCT severity index (CTSI) score, Balthazar CT score and the score of extra-pancreatic inflammation spread) were higher than those with smooth recovery (P < 0.01). The CT scores were positively correlated with the incidence of local complications of SAP. Among the CT indexes, the score of extra-pancreatic inflammation spread showed the larger area under the ROC curve (AUC = 0. 600) than CTSI score and Balthazar CT score. All CT severity indexes had relatively good correlation with APACHE II and Ranson scores.
Conclusion: Among the CT severity indexes, the score of extra-pancreatic inflammation spread is superior to CTSI and Balthazar CT scores in predicting local complications of SAP, and has good correlation with APACHE II and Ranson scores.