Arterial phase enhancement of the adrenal glands as a severity indicator for acute pancreatitis

TL;DR

This study shows that higher CT scan values of adrenal glands during an arterial phase may indicate more severe acute pancreatitis.

Contribution

The study introduces adrenal gland CT values in the arterial phase as a novel severity indicator for acute pancreatitis.

Findings

The maximum CT value of the adrenal glands was significantly higher in acute pancreatitis patients compared to controls.

Adrenal CT values correlated with CRPmax and CAR, suggesting a link to disease severity.

A cut-off value of 180.5 Hounsfield units was identified for severity prediction.

Abstract

To investigate the relationship between the computed tomography (CT) value of the adrenal glands in the arterial phase of dynamic contrast-enhanced CT and the severity of acute pancreatitis.

We measured the maximum CT values of the adrenal glands on the arterial phase of dynamic contrast-enhanced CT of patients with acute pancreatitis and compared them with those of the non-pancreatitis group. Moreover, we evaluated the correlations between the adrenal CT values and maximum C-reactive protein (CRPmax) and CRP/albumin ratio (CAR) in the clinical courses.

In this retrospective study, a total of 68 patients was included. The maximum CT value of the adrenal glands of pancreatitis group was significantly higher than that of the control group (p < 0.001). Significant fair correlations were observed between the adrenal CT value and CRPmax (r = 0.483, p < 0.001) or CAR (r = 0.450, p < 0.001). The cut-off value of the adrenal CT values was determined as 180.5 Hounsfield unit.

In cases of acute pancreatitis, the maximum CT value of the adrenal gland in the arterial phase of dynamic contrast-enhanced CT was significantly higher than in non-pancreatitis controls, and the intensity of the contrast enhancement correlated with the CRPmax and CAR during the subsequent course of pancreatitis. This finding may assist in predicting the severity of acute pancreatitis.

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