The Comparison Of CT/MRI Manifestations With Clinical Characteristics Between Patients With Acute Pancreatitis Associated With And Without Diabetes

Objective: To investigate the CT/MRI manifestations and clinical characteristics of acute pancreatitis associated with diabetes,and to compare those characteristics with those of acute pancreatitis associated without diabetes.Analyzing the differences between these two groups based on CT/MRI severity index(CTSI/MRSI),extrapancreatic inflammation on CT/MR(EPIC/EPIM)and classification for severity of acute pancreatitis in Atlanta to enhance the cognition of radiologist and clinician in acute pancreatitis combine with diabetes.Methods: A total of 340 patients with acute pancreatitis which were confirmed by clinical and laboratory tests were recruited in this study.Of them 62 patients with acute pancreatitis associated with diabetes were served as observation group(diabetes group)and 278 patients with acute pancreatitis associated without diabetes were served as control group(non-diabetes group).First of all,according to the CT/MRI findings,the classification and local complications in the two groups were identified.Then,the severity of acute pancreatitis was respectively graded by CTSI/MRSI(mild,0-3 points;moderate,4-6 points;severe,7-10 points),EPIC/EPIM and 2012 of Atlanta standards and compared between two groups.Finally,combined with the imaging features and clinical data in 2012 of Atlanta,the severity,pathogenesis,clinical manifestation,complication,prognosis were analyzed in two groups by Independent-samples t test,Chi-square test and Fisher exact probability test.Results: In the 340 patients with acute pancreatitis,according to the CT/MRI findings,the prevalence of hemorrhage and necrosis acute pancreatitis was 19.35%(12/62)in diabetes group,which was significantly higher than that of 9.71%(27/278)in non-diabetes group(P<0.05).The prevalence of local complications was 75.80%(47/62)in diabetes group(P<0.05),which was higher than that of 56.12(156/278)in non-diabetes group.The CTSI/MRSI average score was 4.51�2.16 points in diabetes group was higher than that of 3.25�1.69 points in non-diabetes group(P<0.05).The percentages of moderate and severe acute pancreatitis in diabetes group were higher than those in non diabetes group(P<0.05)and the CTSI/MRSI scores of mild,moderate and severe acute pancreatitis in diabetes group were respectively higher than those in non-diabetes group(P<0.05).The average score of EPIC/EPIM in diabetes group was also higher than that in non-diabetes group(P<0.05).The leading causes of acute pancreatitis in diabetes group was hyperlipidemia in 46.77%(29/62)of patients and in non-diabetes group it was gallstone disease in 42.10%(117/278)of patients.According to the Atlanta classification 2012 of acute pancreatitis,the severity of acute pancreatitis associated with diabetes was higher than that of without diabetes(P<0.05).Further,the diabetes group has the higher ratio in general complication,longer average hospital stay and more possibility of ICU treatment than those in control group(P<0.05).Conclusion: The severity of patients with acute pancreatitis associated with diabetes was higher than that without diabetes.In CT/MRI,the prevalence of hemorrhage and necrosis,and local complications were higher,and the inflammation outside the pancreas were heavier and more widespread in diabetes group than those in non-diabetes group.In the clinical evaluating,the diabetes group has the higher prevalence in general complication,longer average hospital stay and more possibility of ICU treatment than non diabetes group.Besides,the hyperlipidemia is the most important pathogenesis for acute pancreatitis associated with diabetes.