MRI versus acute physiology and chronic healthy evaluation Ⅲ score for the assessment of the severity of acute pancreatitis / 中华放射学杂志

ABSTRACT

Objective To study the severity of acute pancreatitis (AP) by using MRI and the acute physiology and chronic healthy evaluation Ⅲ (APACHE Ⅲ ) score, and the correlation between corresponding MRI findings and APACHE Ⅲ scores.Methods One hundred patients with AP undergoing abdominal MRI were recruited in the study. The MRI features of acute pancreatitis were recorded. The severity of AP on MRI was graded by MR severity index (MRSI) as mild (0 to 2 points),moderate ( 3 to 6 points) and severe (7 to 10 points).APACHE Ⅲ score was denoted for AP was as mild ( ＜35 points)and severe ( ≥ 35 points).The local and systematic complications,mortality,need to intense care unit (ICU),and hospitalization time were recorded and compared with MRSI and APACHE Ⅲ score.Nonparametric Spearman correlation was calculated for testing the correlation between the MRSI,the APACHE Ⅲ and hospitalization time.The correlation of clinical results with MRSI and APACHE Ⅲ was calculated by x2 test.Results In the 100 patients with AP,there were respectively 80 and 20 patients with edematous and necrotic pancreatitis on MRI.According to MRSI,34,59 and 7 patients had mild,moderate,and severe acute pancreatitis,respectively.The APACHE Ⅲ score was (24.9 ± 12.2) points.Seventy-seven patients had less than 35 points and 23 patients had more than 35 point of APACHE Ⅲ score.There were significant differences in the local complication,systematic complication,need to ICU among the three groups in MRSI score,respectively( x2 =9.161,19.118,54.767;P ＜ 0.01 ).There was difference in the systematic complication between mild and severe AP in APACHE Ⅲ score(x2 =13.120,P =0.000),but there were no differences (x2 =0.245,x2 =2.568;P ＞ 0.05) in the local complication,need to ICU between mild and severe AP in APACHE Ⅲ score.There was weak correlation ( r =0.235,P =0.019 )between MRSI score and hospitalization time,and no difference (r =0.168,0.105; P ＞ 0.05)between APACHE Ⅲ and MRSI,APACHE Ⅲ and hospitalization time,respectively.Conclusions Both MRSI and APACHE Ⅲ score may predict systematic complications. However,MRSI is superior to APACHE Ⅲ in predicting the local complications,need to ICU,and hospitalization time in patients with acute pancreatitis.