目的探讨急性胰腺炎(acute pancreatitis,AP)的CTSI评分与肝/脾CT值比(liver to spleen CT attenuation value ratio,L/S)的相关性。方法对87例AP患者进行腹部CT扫描,测量肝脏、脾脏CT值并计算L/S。根据CTSI分级标准由两名放射科医师盲...目的探讨急性胰腺炎(acute pancreatitis,AP)的CTSI评分与肝/脾CT值比(liver to spleen CT attenuation value ratio,L/S)的相关性。方法对87例AP患者进行腹部CT扫描,测量肝脏、脾脏CT值并计算L/S。根据CTSI分级标准由两名放射科医师盲法阅片将AP分为轻度、中度、重度组。分析AP评分分级与L/S之间的关系。结果 87例AP患者L/S降低发生率为55%;轻、中、重度AP患者L/S降低发生率分别为23%、53%、88%;轻度、中度、重度AP患者L/S平均值分别为1.07±0.13、0.95±0.20、0.69±0.26。AP的CTSI评分与L/S呈负相关(r=-0.451,P=0.00)。结论肝/脾CT值比可以反映AP的严重程度,随着AP严重程度的增加,肝损伤的发生率也在增加。展开更多
Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomo...Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.展开更多
文摘目的探讨急性胰腺炎(acute pancreatitis,AP)的CTSI评分与肝/脾CT值比(liver to spleen CT attenuation value ratio,L/S)的相关性。方法对87例AP患者进行腹部CT扫描,测量肝脏、脾脏CT值并计算L/S。根据CTSI分级标准由两名放射科医师盲法阅片将AP分为轻度、中度、重度组。分析AP评分分级与L/S之间的关系。结果 87例AP患者L/S降低发生率为55%;轻、中、重度AP患者L/S降低发生率分别为23%、53%、88%;轻度、中度、重度AP患者L/S平均值分别为1.07±0.13、0.95±0.20、0.69±0.26。AP的CTSI评分与L/S呈负相关(r=-0.451,P=0.00)。结论肝/脾CT值比可以反映AP的严重程度,随着AP严重程度的增加,肝损伤的发生率也在增加。
文摘Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.
