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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 2/2018

01-02-2018 | Original Article

Accuracy of early CT findings for predicting disease course in patients with acute pancreatitis

Authors: Onur Taydas, Emre Unal, Ali Devrim Karaosmanoglu, Mehmet Ruhi Onur, Erhan Akpinar

Published in: Japanese Journal of Radiology | Issue 2/2018

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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.
Literature
1.
Spanier B, Bruno MJ, Dijkgraaf MG. Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years 1995–2005. World J Gastroenterol. 2013;19(20):3018–26.CrossRefPubMedPubMedCentral
2.
Vidarsdottir H, Moller PH, Vidarsdottir H, Thorarinsdottir H, Bjornsson ES. Acute pancreatitis: a prospective study on incidence, etiology, and outcome. Eur J Gastroenterol Hepatol. 2013;25(9):1068–75.CrossRefPubMed
3.
Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33(4):323–30.CrossRefPubMed
4.
Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet. 1974;139(1):69–81.PubMed
5.
Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989;2(8656):201–5.CrossRefPubMed
6.
Murphy KP, O’Connor OJ, Maher MM. Updated imaging nomenclature for acute pancreatitis. AJR Am J Roentgenol. 2014;203(5):W464–9.CrossRefPubMed
7.
Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174(2):331–6.CrossRefPubMed
8.
Mortele KJ, Wiesner W, Intriere L, Shankar S, Zou KH, Kalantari BN, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR Am J Roentgenol. 2004;183(5):1261–5.CrossRefPubMed
9.
Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102–11.CrossRefPubMed
10.
Brand M, Gotz A, Zeman F, Behrens G, Leitzmann M, Brunnler T, et al. Acute necrotizing pancreatitis: laboratory, clinical, and imaging findings as predictors of patient outcome. AJR Am J Roentgenol. 2014;202(6):1215–31.CrossRefPubMed
11.
Casas JD, Diaz R, Valderas G, Mariscal A, Cuadras P. Prognostic value of CT in the early assessment of patients with acute pancreatitis. AJR Am J Roentgenol. 2004;182(3):569–74.CrossRefPubMed
12.
Leung TK, Lee CM, Lin SY, Chen HC, Wang HJ, Shen LK, et al. Balthazar computed tomography severity index is superior to Ranson criteria and APACHE II scoring system in predicting acute pancreatitis outcome. World J Gastroenterol. 2005;11(38):6049–52.CrossRefPubMedPubMedCentral
13.
Simchuk EJ, Traverso LW, Nukui Y, Kozarek RA. Computed tomography severity index is a predictor of outcomes for severe pancreatitis. Am J Surg. 2000;179(5):352–5.CrossRefPubMed
14.
Vriens PW, van de Linde P, Slotema ET, Warmerdam PE, Breslau PJ. Computed tomography severity index is an early prognostic tool for acute pancreatitis. J Am Coll Surg. 2005;201(4):497–502.CrossRefPubMed
15.
Pienkowska J, Gwozdziewicz K, Skrobisz-Balandowska K, Marek I, Kostro J, Szurowska E, et al. Perfusion-CT—can we predict acute pancreatitis outcome within the first 24 h from the onset of symptoms? PLoS ONE. 2016;11(1):e0146965.CrossRefPubMedPubMedCentral
16.
Yadav AK, Sharma R, Kandasamy D, Bhalla AS, Gamanagatti S, Srivastava DN, et al. Perfusion CT: can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis? Abdom Imaging. 2015;40(3):488–99.CrossRefPubMed
17.
Spitzer AL, Thoeni RF, Barcia AM, Schell MT, Harris HW. Early nonenhanced abdominal computed tomography can predict mortality in severe acute pancreatitis. J Gastrointest Surg. 2005;9(7):928–33.CrossRefPubMed
18.
Clavien PA, Hauser H, Meyer P, Rohner A. Value of contrast-enhanced computerized tomography in the early diagnosis and prognosis of acute pancreatitis. A prospective study of 202 patients. Am J Surg. 1988;155(3):457–66.CrossRefPubMed
19.
Glazer GMD. United Kingdom guidelines for the management of acute pancreatitis. Gut. 1998;42(Suppl 2):S1–13.
20.
Isenmann R, Buchler M, Uhl W, Malfertheiner P, Martini M, Beger HG. Pancreatic necrosis: an early finding in severe acute pancreatitis. Pancreas. 1993;8(3):358–61.CrossRefPubMed
Metadata
Title
Accuracy of early CT findings for predicting disease course in patients with acute pancreatitis
Authors
Onur Taydas
Emre Unal
Ali Devrim Karaosmanoglu
Mehmet Ruhi Onur
Erhan Akpinar
Publication date
01-02-2018
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 2/2018
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-017-0709-9

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