Sevde Nur Emir, Hasan Kumru, Gülbanu Güner, Aylin Acar, Tolga Canbak
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引用次数: 0
Abstract
Background
Early risk stratification is crucial in acute biliary pancreatitis (ABP) to optimize patient management and guide intensive care unit (ICU) admission decisions. Traditional biomarkers and scoring systems have limitations in early severity assessment. This study aimed to evaluate the predictive value of adrenal contrast ratios on contrast-enhanced CT (CECT) as imaging-based biomarkers for ICU admission and prolonged hospitalization in ABP patients.
Methods
This retrospective study included 288 ABP patients who underwent CECT within 24 h of admission. Adrenal-to-inferior vena cava (IVC) and adrenal-to-spleen contrast ratios were measured from portal venous phase images. The predictive performance of these ratios for ICU admission was assessed using receiver operating characteristic (ROC) analysis, and their correlation with clinical outcomes was evaluated through regression analysis.
Results
ICU-admitted patients had significantly higher adrenal contrast ratios compared to non-ICU patients (adrenal-to-IVC ratio: 1.15 vs. 0.99, p < 0.001; adrenal-to-spleen ratio: 0.97 vs. 0.75, p < 0.001). ROC analysis demonstrated strong predictive accuracy (AUC = 0.74 for adrenal-to-IVC, AUC = 0.81 for adrenal-to-spleen). Additionally, adrenal contrast ratios correlated significantly with prolonged hospital stay (r = 0.49–0.55, p < 0.001).
Conclusion
Adrenal contrast ratios serve as promising imaging-based biomarkers for early ICU admission prediction and risk stratification in ABP patients. Their integration into clinical decision-making may enhance early management strategies. Further prospective validation is warranted.
背景：在急性胆源性胰腺炎（ABP）中，早期风险分层对于优化患者管理和指导重症监护病房（ICU）的入院决定至关重要。传统的生物标志物和评分系统在早期严重程度评估方面存在局限性。本研究旨在评估对比增强CT （CECT）肾上腺对比率作为ABP患者ICU入院和延长住院时间的影像学生物标志物的预测价值。方法：回顾性研究288例ABP患者入院24小时内行CECT。通过门静脉相图像测量肾上腺与下腔静脉（IVC）和肾上腺与脾脏的对比比。采用受试者工作特征（ROC）分析评估这些比值对ICU入院的预测效能，并通过回归分析评估其与临床结局的相关性。结果：ICU患者的肾上腺对比比明显高于非ICU患者（肾上腺与ivc比值：1.15 vs. 0.99, p）。结论：肾上腺对比比是ABP患者早期ICU入院预测和风险分层的有希望的基于成像的生物标志物。将它们整合到临床决策中可以增强早期管理策略。进一步的前瞻性验证是必要的。
期刊介绍：
Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section.
Reasons to Publish Your Article in Abdominal Radiology:
· Official journal of the Society of Abdominal Radiology (SAR)
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European Society of Gastrointestinal and Abdominal Radiology (ESGAR)
European Society of Urogenital Radiology (ESUR)
Asian Society of Abdominal Radiology (ASAR)
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