Clinical Study Of CT Abdominal Fat Analysis To Evaluate The Severity Of Acute Pancreatitis And Modified EPIC Score

Objective:To evaluate the visceral fat parameters of patients with acute pancreatitis using plain CT scan and EPIC score,to explore the correlation between visceral fat parameters,EPIC score and the severity of acute pancreatitis,and to include the best visceral fat parameters in the EPIC score.And improve the diagnostic efficacy of EPIC score to evaluate the severity of patients with acute pancreatitis.Methods:This study retrospectively analyzed the basic data and CT abdominal fat data of 91 patients with acute pancreatitis who met the inclusion criteria in our hospital.According to the clinical comprehensive assessment of the "Guidelines for the Diagnosis and Treatment of Acute Pancreatitis in China(2013,Shanghai)",the patients were divided into two groups,mild acute pancreatitis group;moderate severe acute pancreatitis and severe acute pancreatitis,namely non-mild acute pancreatitis group.Calculate the EPIC score and BISAP score of all patients.The CT plain scan image of the abdomen was analyzed at the image post-processing workstation.The reference level of body fat analysis is about the level of the umbilical plane.Obtained body fat analysis data include visceral fat area(VFA),VFA%),Subcutaneous fat area,total fat area.Statistical analysis was performed using SPSS22.0 statistical software,and the best visceral fat parameters were screened for correlation analysis with EPIC score and BISAP score results.Determine the best cutoff value of the best visceral fat parameters,and fuse this with the EPIC score to form an improved EPIC score and calculate its Jordan index.The area under the ROC curve was used to compare the best visceral fat parameters,EPIC score,and EPIC modified score to predict the diagnostic efficacy of the severity of acute pancreatitis.Results:1.43 patients in the mild acute pancreatitis group and 48 patients in the non-mild acute pancreatitis group.The VFA and VFA% of patients in non-mild acute pancreatitis group were statistically different from those in patients with mild acute pancreatitis group(P <0.05),and the P value of VFA% was less than 0.01.2.VFA% and EPIC score(?= 0.845,P <0.001)and BISAP score(?= 0.548,P =0.03)were correlated.3.When the VFA% cutoff value is 0.480,the Jordan index for predicting the severity of acute pancreatitis is 0.387,and the EPIC score is the Jordan index for predicting the severity of acute pancreatitis is 0.340.4.Take the VFA% cutoff value as 0.480 and improve When the EPIC score is ?4,the Jordan index of patients with non-mild acute pancreatitis is predicted to be 0.428;when the modified EPIC score is ?5,the Jordan index of patients with non-mild acute pancreatitis is predicted to be 0.453.Conclusion:1.VFA% is positively correlated with the severity of acute pancreatitis and can predict the severity of acute pancreatitis.2.When the VFA% cutoff value is 0.480 and the modified EPIC score is ? 5,it is predicted that the patient has the highest diagnostic efficacy for non-mild acute pancreatitis.3.VFA% may be a reference index for evaluating the prognosis of patients with acute pancreatitis,and should be considered for future acute pancreatitis imaging scores.