Clinical Value of Energy Spectrum Computed Tomography Imaging in Evaluating the Severity of Acute Pancreatitis
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v7i1.5078
Abstract
Objective: The value of spectral computed tomography in evaluating the severity of acute pancreatitis (AP). Methods: We selected 54 patients with AP (treated between June 2024 and November 2025) and divided them into mild, moderate, and severe AP groups by employing the Revised Atlanta classification (RAC) and iodine concentration (IC) and standardized iodine concentration (NIC) values were recorded. These parameters were combined with procalcitonin, interleukin-6, haematocrit, and D-dimer levels to predict the condition of severity AP. Results: Differences in procalcitonin, interleukin-6, and hospital stay were significant (P < 0.05). IC and NIC also differed significantly between groups (P < 0.05). ROC analysis showed AUCs of 0.661, 0.748, 0.554, 0.534 for procalcitonin, interleukin-6, D-dimer, and haematocrit, respectively. IC achieved an AUC of 0.834, with an optimal cutoff of 2.7 mg/mL for diagnosing moderate-severe AP. Conclusion: Spectral CT has clinical guiding value in the diagnosis of AP.
Keywords
acute pancreatitis; spectral spectrum computed tomography; severity
Full Text
PDF - Viewed/Downloaded: 2 TimesReferences
[1] Mederos MA, Reber HA, Girgis MD. Acute Pancreatitis: A Review. JAMA. 2021;325(4):382-390. doi:10.1001/jama.2020.20317
[2] Werge M, Novovic S, Schmidt PN, Gluud LL. Infection increases mortality in necrotizing pancreatitis: A systematic review and meta-analysis. Pancreatology. 2016;16(5):698-707. doi:10.1016/j.pan.2016.07.004
[3] Zhao K, Adam SZ, Keswani RN, Horowitz JM, Miller FH. Acute Pancreatitis: Revised Atlanta Classification and the Role of Cross-Sectional Imaging. AJR Am J Roentgenol. 2015;205(1):W32-W41. doi:10.2214/AJR.14.14056
[4] Lee DW, Cho CM. Predicting Severity of Acute Pancreatitis. Medicina (Kaunas). 2022;58(6):787. Published 2022 Jun 11. doi:10.3390/medicina58060787
[5] Brown CL, Hartman RP, Dzyubak OP, et al. Dual-energy CT Iodine overlay technique for characterization of renal masses as cyst or solid: a phantom feasibility study. Eur Radiol, 2009, 19(5): 1289-1295.
[6] Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi:10.1136/gutjnl-2012-302779
[7] 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. doi:10.2214/ajr.183.5.1831261
[8] Cuthbertson CM, Christophi C. Disturbances of the microcirculation in acute pancreatitis. Br J Surg. 2006;93(5):518-530. doi:10.1002/bjs.5316
[9] Antkowiak R, Bialecki J, Chabowski M, Domoslawski P. Treatment of Microcirculatory Disturbances in Acute Pancreatitis: Where Are We Now?. Pancreas. 2022;51(5):415-421. doi:10.1097/MPA.0000000000002044
[10] Habtezion A, Gukovskaya AS, Pandol SJ. Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions. Gastroenterology. 2019;156(7):1941-1950. doi:10.1053/j.gastro.2018.11.082
[11] Barrera Gutierrez JC, Greenburg I, Shah J, et al. Severe acute pancreatitis prediction: a model derived from a prospective registry cohort［J］. Cureus, 2023, 15(10): e46809.
[12] Xue E, Shi Q, Guo S, et al. Preexisting diabetes, serum calcium and D-dimer levels as predictable risk factors for pancreatic necrosis of patients with acute pancreatitis: a retrospective study. Expert Rev Gastroenterol Hepatol. 2022;16(9):913-921. doi:10.1080/17474124.2022.2116314
[13] Mahmoudi S, Martin S, Koch V, et al. Value of Dual-Energy CT Perfusion Analysis in Patients with Acute Pancreatitis: Correlation and Discriminative Diagnostic Accuracy with Varying Disease Severity. Diagnostics (Basel). 2022;12(11):2601. Published 2022 Oct 27.
[14] Hamada H, Fujii T, Kittaka D, Nakai Y, Sato H, Kato K. Dual Energy CT for determining the severity of acute pancreatitis. Showa Univer J Med Sci 2023; 35: 11-18.
[2] Werge M, Novovic S, Schmidt PN, Gluud LL. Infection increases mortality in necrotizing pancreatitis: A systematic review and meta-analysis. Pancreatology. 2016;16(5):698-707. doi:10.1016/j.pan.2016.07.004
[3] Zhao K, Adam SZ, Keswani RN, Horowitz JM, Miller FH. Acute Pancreatitis: Revised Atlanta Classification and the Role of Cross-Sectional Imaging. AJR Am J Roentgenol. 2015;205(1):W32-W41. doi:10.2214/AJR.14.14056
[4] Lee DW, Cho CM. Predicting Severity of Acute Pancreatitis. Medicina (Kaunas). 2022;58(6):787. Published 2022 Jun 11. doi:10.3390/medicina58060787
[5] Brown CL, Hartman RP, Dzyubak OP, et al. Dual-energy CT Iodine overlay technique for characterization of renal masses as cyst or solid: a phantom feasibility study. Eur Radiol, 2009, 19(5): 1289-1295.
[6] Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-111. doi:10.1136/gutjnl-2012-302779
[7] 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. doi:10.2214/ajr.183.5.1831261
[8] Cuthbertson CM, Christophi C. Disturbances of the microcirculation in acute pancreatitis. Br J Surg. 2006;93(5):518-530. doi:10.1002/bjs.5316
[9] Antkowiak R, Bialecki J, Chabowski M, Domoslawski P. Treatment of Microcirculatory Disturbances in Acute Pancreatitis: Where Are We Now?. Pancreas. 2022;51(5):415-421. doi:10.1097/MPA.0000000000002044
[10] Habtezion A, Gukovskaya AS, Pandol SJ. Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions. Gastroenterology. 2019;156(7):1941-1950. doi:10.1053/j.gastro.2018.11.082
[11] Barrera Gutierrez JC, Greenburg I, Shah J, et al. Severe acute pancreatitis prediction: a model derived from a prospective registry cohort［J］. Cureus, 2023, 15(10): e46809.
[12] Xue E, Shi Q, Guo S, et al. Preexisting diabetes, serum calcium and D-dimer levels as predictable risk factors for pancreatic necrosis of patients with acute pancreatitis: a retrospective study. Expert Rev Gastroenterol Hepatol. 2022;16(9):913-921. doi:10.1080/17474124.2022.2116314
[13] Mahmoudi S, Martin S, Koch V, et al. Value of Dual-Energy CT Perfusion Analysis in Patients with Acute Pancreatitis: Correlation and Discriminative Diagnostic Accuracy with Varying Disease Severity. Diagnostics (Basel). 2022;12(11):2601. Published 2022 Oct 27.
[14] Hamada H, Fujii T, Kittaka D, Nakai Y, Sato H, Kato K. Dual Energy CT for determining the severity of acute pancreatitis. Showa Univer J Med Sci 2023; 35: 11-18.
Copyright © 2026 Yi Feng, Bihui Yao, Lu Liang
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License