Correlative Analysis of Three Computed Tomography Imaging Scoring to Bedside Index of Severity in Acute Pancreatitis in Evaluating for Severe Acute Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WANGYi , LENGQi , HUANGZi-xing ,  SONGBin

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

SONGBin, Email: cjr.songbin@vip.163.com

Keywords：

Severe acute pancreatitis; Bedside index for severity in acute pancreatitis; CT severity index; Modified CT severity index; Extra-pancreatic inflammation on CT

DOI：

10.7507/1007-9424.20150396

Video：

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Objective To investigate correlation of bedside index for severity in acute pancreatitis(BISAP) and computed tomography severity index(CTSI), modified computed tomography severity index(MCTSI), or extra-pancreatic inflammation on CT(EPIC) score, respectively, in assessing severity of acute pancreatitis. Methods Forty-five patients confirmed SAP from July 2015 to November 2015 in West China Hospital of Sichuan University were prospectively included into this study. Contrast-enhanced multi-detector-row 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 three CT severity indexes(CTSI, MCTSI, and EPIC). The clinical data were also colle-cted to calculate BISAP and as compared with CT severity indexes. Correlation between the CT indexes points and BISAP score was estimated using the Spearman test. Interobserver agreement for CTSI, MCTSI or EPIC was calculated using the Kappa statistic. Results The results of BISAP score were as follows: 4 cases gradeⅠ, 22 cases gradeⅡ, 19 cases gradeⅢ. The results of CTSI score were as follows: 6 cases gradeⅠ, 22 cases gradeⅡ, 17 cases gradeⅢ. The results of MCTSI score were as follows: 1 case gradeⅠ, 13 cases gradeⅡ, 31 cases gradeⅢ. The results of EPIC score were as follows: 6 cases gradeⅠ, 11 cases gradeⅡ, 28 cases gradeⅢ. The score of BISAP, CTSI, MCIST, or EPIC was 2.41±0.82, 6.02±1.96, 7.91± 2.11, and 5.57±1.52, respectively. Interobserver agreements for CTSI, MCTSI, and EPIC were good(CTSI: Kappa=0.748, 95% CI 0.000-0.076, P < 0.01; MCTSI: Kappa=0.788, 95% CI 0.000-0.076, P < 0.01; EPIC: Kappa=0.768, 95% CI 0.000-0.076, P < 0.01). Spearman statistic showed there was a positive correlation between CTSI score(r_s=0.439, P=0.003), MCTSI score(r_s=0.640, P=0.000), or EPIC(r_s=0.503, P=0.001) and BISAP score. Conclusion There is a positive correlation between MCTSI or EPIC and BISAP score, and MCTSI is more strongly correlated with BISAP as compared with EPIC.

Citation： WANGYi, LENGQi, HUANGZi-xing, SONGBin. Correlative Analysis of Three Computed Tomography Imaging Scoring to Bedside Index of Severity in Acute Pancreatitis in Evaluating for Severe Acute Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(12): 1520-1524. doi: 10.7507/1007-9424.20150396 Copy

1.	王兴鹏, 李兆申, 袁耀宗, 等.中国急性胰腺炎诊治指南(2013, 上海).中国实用内科杂志, 2013, 18(7): 530-535.
2.	Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut, 2008, 57(12): 1698-1703.
3.	Bollen TL, Singh VK, Maurer R, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis. Am J Gastroenterol, 2012, 107(4): 612-619.
4.	Mortele KJ, Wiesner W, Intriere L, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR Am J Roentgenol, 2004, 183(5): 1261-1265.
5.	Sun JK, Li WQ, Ni HB, et al. Modified gastrointestinal failure score for patients with severe acute pancreatitis. Surg Today, 2013, 43(5): 506-513.
6.	Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancr-eatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1): 102-111.
7.	周航, 罗放.早期急性胰腺炎严重性评价进展.检验医学与临床, 2014, 11(9): 1267-1268, 1297.
8.	Balthazar EJ, Ranson JH, Naidich DP, et al. Acute pancreatitis: prognostic value of CT. Radiology, 1985, 156(3): 767-772.
9.	Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology, 1990, 174(2): 331-336.
10.	De Waele JJ, Delrue L, Hoste EA, et al. Extrapancreatic inflamma-tion on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. Pancreas, 2007, 34(2): 185-190.
11.	张圣道, 雷若庆.我国重症急性胰腺炎治疗的效果和评价.外科理论与实践, 2001, 6(1): 10-11.
12.	Bollen TL, Singh VK, Maurer R, et al. Comparative evaluation of the modified CT severity index and CT severity index in assessing severity of acute pancreatitis. AJR Am J Roentgenol, 2011, 197(2): 386-392.
13.	Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroen-terol, 2010, 105(2): 435-442.
14.	Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol, 2009, 104(4): 966-971.
15.	Gao W, Yang HX, Ma CE. The value of BISAP score for predicting mortality and severity in acute pancreatitis: a systematic review and meta-analysis. PLoS One, 2015, 10(6): e0130412.
16.	Chen L, Lu G, Zhou Q, et al. Evaluation of the BISAP score in predicting severity and prognoses of acute pancreatitis in Chinese patients. Int Surg, 2013, 98(1): 6-12.
17.	Sharma V, Rana SS, Sharma RK, et al. A study of radiological scoring system evaluating extrapancreatic inflammation with conventional radiological and clinical scores in predicting outcomes in acute pancreatitis. Ann Gastroenterol, 2015, 28(3): 399-404.
18.	张薇薇, 李峥艳, 黄子星, 等.重症急性胰腺炎CT胰外炎性浸润程度与临床严重程度的相关性分析.四川大学学报:医学版, 2011, 42(5): 699-703.
19.	李峥艳, 张凌, 金涛, 等. CT评分与重症急性胰腺炎合并急性肾损伤的相关性分析.四川大学学报:医学版, 2011, 42(5): 695-698.

1. 王兴鹏, 李兆申, 袁耀宗, 等.中国急性胰腺炎诊治指南(2013, 上海).中国实用内科杂志, 2013, 18(7): 530-535.
2. Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut, 2008, 57(12): 1698-1703.
3. Bollen TL, Singh VK, Maurer R, et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis. Am J Gastroenterol, 2012, 107(4): 612-619.
4. Mortele KJ, Wiesner W, Intriere L, et al. A modified CT severity index for evaluating acute pancreatitis: improved correlation with patient outcome. AJR Am J Roentgenol, 2004, 183(5): 1261-1265.
5. Sun JK, Li WQ, Ni HB, et al. Modified gastrointestinal failure score for patients with severe acute pancreatitis. Surg Today, 2013, 43(5): 506-513.
6. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancr-eatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1): 102-111.
7. 周航, 罗放.早期急性胰腺炎严重性评价进展.检验医学与临床, 2014, 11(9): 1267-1268, 1297.
8. Balthazar EJ, Ranson JH, Naidich DP, et al. Acute pancreatitis: prognostic value of CT. Radiology, 1985, 156(3): 767-772.
9. Balthazar EJ, Robinson DL, Megibow AJ, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology, 1990, 174(2): 331-336.
10. De Waele JJ, Delrue L, Hoste EA, et al. Extrapancreatic inflamma-tion on abdominal computed tomography as an early predictor of disease severity in acute pancreatitis: evaluation of a new scoring system. Pancreas, 2007, 34(2): 185-190.
11. 张圣道, 雷若庆.我国重症急性胰腺炎治疗的效果和评价.外科理论与实践, 2001, 6(1): 10-11.
12. Bollen TL, Singh VK, Maurer R, et al. Comparative evaluation of the modified CT severity index and CT severity index in assessing severity of acute pancreatitis. AJR Am J Roentgenol, 2011, 197(2): 386-392.
13. Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis. Am J Gastroen-terol, 2010, 105(2): 435-442.
14. Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis. Am J Gastroenterol, 2009, 104(4): 966-971.
15. Gao W, Yang HX, Ma CE. The value of BISAP score for predicting mortality and severity in acute pancreatitis: a systematic review and meta-analysis. PLoS One, 2015, 10(6): e0130412.
16. Chen L, Lu G, Zhou Q, et al. Evaluation of the BISAP score in predicting severity and prognoses of acute pancreatitis in Chinese patients. Int Surg, 2013, 98(1): 6-12.
17. Sharma V, Rana SS, Sharma RK, et al. A study of radiological scoring system evaluating extrapancreatic inflammation with conventional radiological and clinical scores in predicting outcomes in acute pancreatitis. Ann Gastroenterol, 2015, 28(3): 399-404.
18. 张薇薇, 李峥艳, 黄子星, 等.重症急性胰腺炎CT胰外炎性浸润程度与临床严重程度的相关性分析.四川大学学报:医学版, 2011, 42(5): 699-703.
19. 李峥艳, 张凌, 金涛, 等. CT评分与重症急性胰腺炎合并急性肾损伤的相关性分析.四川大学学报:医学版, 2011, 42(5): 695-698.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Correlative Analysis of Three Computed Tomography Imaging Scoring to Bedside Index of Severity in Acute Pancreatitis in Evaluating for Severe Acute Pancreatitis

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