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Congress: ECR24
Poster Number: C-11553
Type: EPOS Radiologist (scientific)
Authorblock: F. Porões1, N. Vietti Violi2, E. Uldry2, T. Hilbert2, F. Schütz2, S. Schmidt Kobbe2; 1Fribourg/CH, 2Lausanne/CH
Disclosures:
Fabio Porões: Nothing to disclose
Naïk Vietti Violi: Nothing to disclose
Emilie Uldry: Nothing to disclose
Tom Hilbert: Nothing to disclose
Frédéric Schütz: Nothing to disclose
Sabine Schmidt Kobbe: Nothing to disclose
Keywords: Abdomen, MR, Technology assessment, Oedema
Results

Patients

A total of 95 consecutive patients diagnosed with AP were admitted to the Visceral surgery Department of CHUV between December 2020 and November 2022. The process of patient inclusion is shown in Figure 4.

Fig 4: Flow chart showing the process of patient inclusion.
Our final study population consisted of 76 patients (39 women; mean age 53.17 ± 17.89 years, range: 20-91 years).
Table 5: General characteristics of the study population.

Inter-observer reproducibility

The ICC was good between the two readers for the overall analysis (0.85, 95% confidence interval (CI) = 0.77–0.90), as well as for each anatomical location (0.80, 95% CI = 0.75–0.84). 

T2 values across the three anatomical locations and CT LocIn Score

We found no significant difference in T2 values across the anatomical locations. The mean T2 values were 76 ± 18, 76 ±18, and 76 ± 18 msec in the head, body, and tail of the pancreas, respectively.

However, T2 values in the same patient for the three different anatomical regions of the pancreas correlated positively with the presence of inflammation using the specially developed CT LocIn Score (head: Rs(76) = 0.74, P < 0.001; body: Rs(76) = 0.66: P < 0.001; tail: Rs(76) = 0.52: P < 0.001; all three anatomical regions together: Rs(228) = 0.64, P < 0.001).

T2 values and correlation with patient characteristics and AP severity

No significant correlation was found between the T2 values and patient age (Rs(76) = 0.18; P = 0.13), sex (male: 77 ± 18 msec, female: 75 ± 14 msec; t(65) = -0.44; P = 0.66), BMI (Rs(75) = 0.06; P = 0.61) or main pancreatic duct dilatation (presence of dilatation: 86 ± 21 msec, absence of dilatation: 75 ± 15 msec; t(9) = -1.54; P = 0.16).

Spearman correlation revealed a significant positive association between T2 values and the length of hospital stay (Rs (76) = 0.29, P = 0.01).

Fig 6: Correlations between mean T2 values (ms) and the length of hospital stay (days).
There was also a significant difference in T2 values between patients hospitalized < 5 and > 5 days (length of hospital stay < 5 days: 70 ± 12 msec, length of hospital stay > 5 days: 81 ± 16 msec; t (65) = 3.37; P < 0.01). The AUC of the ROC curve showing the predictive power of the T2 values for a hospital stay <5 days was 0.68.
Fig 7: Receiver operating characteristic (ROC) curve of the performance of T2 mapping for prediction of hospital stay < 5 days. The area under the curve of this ROC curve was 0.68 (P < 0.01).

For the exploratory outcomes, T2 values correlated significantly with the CTSI (Rs (73) = 0.61, P < 0.001; CTSI 0-3: 72 ±14 msec, CTSI 4-10: 88 ± 15; t(29.05) = -3.87; P < 0.001),

Fig 8: Correlations between mean T2 values (ms) and CTSI (0-10).
ICU admission (ICU admission: 92 ± 8 msec, no ICU admission: 75 ± 16 msec; t(2.77) = -3.41; P < 0.05),
Fig 9: Comparison of mean T2 values (ms) in patient with and without admission to the intensive care unit.
and presence of organ failure (presence of organ failure: 92 ± 11 msec, absence of organ failure: 75 ± 16 msec; t(6.72) = -3.42; P = 0.01).
Fig 10: Comparison of mean T2 values (ms) in patient with and without organ failure.
We found a statistically significant relationship between T2 values and laboratory values. Corresponding Spearman correlation coefficients (Rs) and P values are provided in Table 11.
Table 11: Correlation between T2 values and acute pancreatitis severity.

Comparisons between T2 mapping, CTSI, and the Ranson score are shown in Table 12.

Table 12: Comparison of scoring systems for acute pancreatitis severity.
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GALLERY