Sang Soo Shin MD, Presenter: Nothing to Disclose

Jin Woong Kim MD, Abstract Co-Author: Nothing to Disclose

Yong Yeon Jeong, Abstract Co-Author: Nothing to Disclose

Suk Hee Heo MD, Abstract Co-Author: Nothing to Disclose

Heoung Keun Kang, Abstract Co-Author: Nothing to Disclose

To compare the correlation of three different CT grading systems (CT grade, CT severity index, modified CT severity index) with patient’s outcome for the evaluation of acute pancreatitis.

During a recent 40-month period, 165 consecutive patients (109 men, 56 women; age range, 18-85 years; mean, 57.2 years) with a primary diagnosis of acute pancreatitis, who had undergone contrast-enhanced CT within 1 week of onset of symptoms at our institution, were enrolled in this study. CT examinations were performed by using spiral CT (n=109), 4-slice MDCT (n=13), 16-slice MDCT (n=14), or 64-slice MDCT (n=29) scanner. Scoring of CT images according to the severity of acute pancreatitis was performed in consensus by two radiologists, who were unaware of patient’s outcome, using three different CT grading systems. Outcome parameters included the length of hospital stay, surgery or percutaneous intervention, evidence of infection, occurrence of complications (abscess, pseudocyst, organ failure). For three different CT grading systems, correlation with patient’s outcome was analyzed.

The length of hospital stay was significantly longer in patients with severe degree of pancreatitis using CT grade, CT severity index, and modified CT severity index (p< .001, p< .001, p< .001, respectively). Surgery or percutaneous intervention and complications were more frequently found in patients with severe degree of pancreatitis using CT grade (p= .034, p= .023, respectively), CT severity index (p< .001, p= .002, respectively) and modified CT severity index (p= .004, p= .018, respectively). For evidence of infection, there was no significant correlation with all three CT grading systems. The pancreatic necrosis was found in 25% of patients with severe degree of pancreatitis using CT grade.

The CT grade, CT severity index and modified CT severity index correlated closely with patient’s outcome with similar discrimination value. CT grade was not sensitive for predicting the presence of pancreatic necrosis.

CT grade in combination with the presence or absence of pancreatic necrosis could be alternatively used to help identify disease severity instead of more complex CT scoring systems.

Shin, S, Kim, J, Jeong, Y, Heo, S, Kang, H, Prognostic Value of CT for the Evaluation of Patients with Acute Pancreatitis: Comparison of CT Grade, CT Severity Index, and Modified CT Severity Index.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6019491.html