MCTSI in the Evaluation of Acute Pancreatitis and its Prognostic Correlation

Contrast Enhanced CT (CE-CT) is considered to be the gold standard imaging modality in the evaluation of patients with acute pancreatitis [1]. Multiple factor scoring systems are available which are difficult to use and have poor predictive powers. Imaging based scoring is found to be more relevant [2]. Modified CT severity index (MCTSI), proposed by Mortele et al. [3], correlates more closely with the patient outcome measures like the occurrence of infections, organ failure, the need for surgical or percutaneous intervention, the length of hospital stay, and death. The aim of this study is to grade the CT findings of patients with acute pancreatitis according to the modified CT severity index and to correlate the grading system with patient outcome. Over a period of 24 months, 30 patients on clinical suspicion/diagnosis of acute pancreatitis referred to Department of Radio-diagnosis, K. S Hegde Medical Hospital for computed tomography scan of abdomen and pelvis were studied. They were included in the study if they met the inclusion and exclusion criteria. The severity of pancreatitis was scored using Modified CT severity index and the clinical outcome parameters were collected for correlation. Out of the 30 cases with acute pancreatitis, it was observed that males were more commonly affected than females.56.7 % had severe, 40 % had moderate and only one patient in the sample had pancreatitis which was classified as mild according to MCSTI score. Duration of hospital stay, percentage of mortality and interventions that the patients had to undergo due to the complications was much higher among those patients who had higher severity according to MCTSI score. CECT of was found to be an excellent imaging modality to diagnose acute pancreatitis and its complications. The Modified CT Severity Index is an easy tool which helps in grading the severity of acute pancreatitis, with statistically significant positive correlation of MCTSI score found with that of frequency of intervention and a trend of positive correlation with duration of hospital stay and mortality