Keywords : Modified computerized tomography severity index (MCTSI)
Retrospective study: Evaluation of CT imaging spectrum in acute pancreatitis, its severity and complications in tertiary care center
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 5070-5081
Aims and objectives: Our emphasis is to describe the spectrum of imaging findings of
acute pancreatitis with its severity, age distribution, CECT findings and complications
of AP, considering revised Atlanta classification system (2012)5 and MCTSI [3-9].
Materials and methods: A cross sectional study was conducted from 1st sept 2019 to 30th
oct 2021 on patients coming for CT scan of acute onset upper abdominal pain with
nausea and vomiting within 7days of onset of symptoms. Reporting was done by 4
radiologists using recent terminology of revised Atlanta classification system (2012)5-7-
12and MCTSI introduced by Mortele et al [3-9] in 2004.
Results; Revised Atlanta classification system (2012)5 sub divide AP into mild, moderate
and severe according to MCTSI. It also describes various terminology used in reporting
of case of AP. Current study reveals that acute pancreatitis commonly affect male -36
patients (85.7%), with peak incidence and prevalence is among 30-39 year of age group
21 patients (50%). In cases of AP, AIEP is most common 30 (71.4%) patients, and in
AIEP moderate involvement 23 (54.7%) of pancreases is common. ANP is less common
but more severe form of AP and affect male with moderate to severe involvement of
pancreas and also more complications associated with it. Female affected by AP is less
common and only cases of AIEP found with mild to moderate involvement. On CECT
imaging findings bulky and edematous pancreas with peri pancreatic fat stranding is
found in almost all patients. Other findings seen in cases of moderate and severely
involved pancreas is in decreasing order as Pancreatic or peripancreatic fluid collection
or peripancreatic fat necrosis-23 (54.7%), ascites- 20 (47.6%), pleural effusion-19
(45.2)%, MPD involvement-7 (16.6%), GIT and mesentery involvement-6 (14.2%), PPC
-6(14.2%), WON-5 (12%), cholelithiasis- 4 (9.5%), pancreatic necrosis-2 (4.7%). Peak
age group of AP is found to be from 30-39y which affect 21 (50) % patients.
Conclusion; MCTSI is a simple scoring system to apply and predict severity accurately,
whichhelps in making early diagnosis of acute pancreatitis,triaging of patients
according to severity, establishment of treatment, management of associated
complications and for follow up examinations. Recent terminology of revised Atlanta
classification system is easy to understand and uniformly accepted by clinicians.