The Correlative Study About MCTSI And BISAP Scoring And The Vascular Complications Of Acute Pancreatitis

Part one The correlation between MCTSI within 72 hours after onset andBISAP scoring and prognosisObjectives: To discuss the relationship between MCTSI scoring and BISAP scoring in acute pancreatitis(AP) and to investigate the value of MCTSI score in predicting the prognosis of acute pancreatitis at the same time.Methods: 37 patients with acute pancreatitis were retrospectively analyzed between 2012 and 2015.All patients were hospitalized within 24 hours after onset of symptoms indicative of acute pancreatitis and underwent CECT in 72 hours. All case have holonomic laboratory data required in BISAP scoring.BISAP and Modified CT Severity Index(MCTSI) of all patients were calculated.The relationship between MCTSI scoring and BISAP scoring were discussed by using Spearman rank correlation analysis.The relationship between MCTSI scoring and the prognosis of acute pancreatitis were discussed by using chi-square test at the same time.Results: among the 37 cases,there were 8 cases with mild AP,23 cases with moderate AP and 6 cases with severe AP;The MCTSI scoring of AP were 5.08±2.34;The BISAP scoring of AP were 1.59±1.19;The MCTSI scoring was positively correlated with BISAP scoring in AP(r=0.648,P=1.45×10-5).The MCTSI scoring was positively correlated with the prognosis of AP(χ2=15.09,r=0.481,P<0.05).Conclusions: For the patients with AP,MCTSI could reflect the the extent,degree and the lesions outside pancreas.The modified CTSI correlates more closely with BISAP scoring and patient outcome. Part two Correlation analysis of computed tomography imaging score with the presence of vascular complications of acute pancreatitisObjectives: The aim of the study is to investigate the CT imaging findings of acute pancreatitis(AP) complicated with vascular disease and to evaluate the correlation between the modified CT imaging score(MCTSI) and the presence of vascular complications in AP.Methods: Contrast-enhanced CT( CECT) was performed to 251 patients.Among them,82 patients complicated with vascular lesions.The imaging characteristics include thrombosis,narrow of vascular, pseudoaneurysm formation and hemorrhage, left-sided portal hypertension, etc.Meanwhile,the correlation between the prevalence of complications and MCTSI was estimated using Spearman test.Results: 32.7%(82/521) AP patients complicated with vascular abnormalities. There were 32.9%(27/82) patients complicated with splanchnic vein thrombosis,including thrombosis of splenic vein(SV) 16 cases(59.3%), the portal vein(PV) 3 cases(11.1%), and superior mesenteric vein(SMV) 2 cases(7.4%),thrombosis of SV and PV 3 cases(11.1%),thrombosis of SV,PV and SMV 2 cases(7.4%),and thrombosis of the right gonad vein 1 case(3.7%).Pseudoaneurysm of splenic artery and hemorrhage in pancreatic pseudocyst were detected for 1 and 1 case separately(1.2%).Stenosis of splanchnic veins were found to 18 cases(22%),including 8 cases(44.4%) in SV, 5 cases(27.8%) in PV, 4 cases(22.2%) in SMV,and 1 case(5.6%) in SV,PV and SMV.Among 40 cases(48.8%) with left-sided portal hypertension,15 cases(37.5%) were accompanied with thrombosis or/and stenosis,and 2 cases(5%) with dilation of bile duct.Certain correlation was found between the MCTSI and the stenosis of PV(r=0.263,p=0.018). By using the ROC curve to evaluate the accuracy of the MCTSI in predicting the incidence of vascular complication,we observed that the area under the curve(AUC) was 0.651(95%CI 5.05-7.97). The sensitivity and specificity for predicting vascular complication based on a MCTSI score of 3 points are 80.2% and 50.0% respectively.Conclusions: AP with vascular complication is not rare.The MCTSI is correlated with stenosis of PV.When the MCTSI score is more than 3 points,MCTSI may predict the occurance of vascular complication.