Correlation analysis of computed tomography imaging score with the presence of acute kidney injury in severe acute pancreatitis

Objectives The aim of the study is to investigate the CT imaging findings of severe acute pancreatitis (SAP) complicated with acute kidney injury (AKI) and evaluate the correlation between the CT imaging score and the presence of AKI in SAP. Materials and methods Contrast-enhanced CT scanning was performed for all 145 patients. Related CT indices such as Balthazar CT grading, CTSI and EPIC scores were calculated. Clinical data, including APACHE II, Ranson scores, serum creatinine levels, urine output, and mortality, were then collected and compared with CT indices. Results The EPIC score showed a larger area under the receiver operating characteristic curve than either of the CTSI or Balthazar score. However, the change of APACHE II score, but not EPIC score, was significantly associated with the prognosis of AKI and eventual clinical outcome. In addition, the CT manifestation of fluid encapsulation was a good predictor of recovery from AKI. Conclusions Among the CT indices, the EPIC score, which possessed a good correlation with both APACHE II and Ranson scores, provided a better prediction of AKI in SAP patients than CTSI and Balthazar scores. Encapsulation of inflammatory exudates might be used in the future as imaging-based prognostic criteria of recovering from AKI in patients with SAP.