Correlation between CT imaging of acute pancreatitis-associated lung injury and perirenal space involvement
LIN Congcong
LIN Yongkai
LI Yuanzhang
CHEN Yongqiang
LIANG Jianhua
Abstract：Objective To retrospectively analyzed the CT imaging features of acute pancreatitis-associated lung injury and investigate the correlation among the severity of acute pancreatitis(AP),the extent of lung tissue injury,and involvement of the perirenal space.Methods A retrospective analysis involving 402 patients diagnosed with AP based on clinical and laboratory examinations were conducted.Clinical data and chest/upper abdomen CT imaging records were collected for analysis.Severity of AP was stratified into categories of mild AP and severe AP using the CT severity indices.Lung injury severity was assessed morphologically and categorized as normal lung tissue,mild lung injury,moderate lung injury,or severe lung injury based on CT findings.Additionally,perirenal space involvement was determined by evaluating renal fascia thickness.Results Based on high resolution CT imaging,the incidence of AP-associated lung injury was 82.34%(331/402)among the AP patients,comprising 264 cases of mild lung injury,34 cases of moderate lung injury,and 33 cases of severe lung injury.The imaging characteristics of AP-associated lung injury include pleural thickening,subpleural lines,and broncho vascular bundle thickening in 258 cases,septal thickening in 46 cases,and patchy consolidation in the lungs or with associated pleural effusion in 48 cases.Univariate analysis showed that the degree of lung injury demonstrated a significant correlation(P<0.05)with age,serum lipase level(>300 U/L),pancreatic CT grading,PS.In the multinomial logistic regression analysis,using normal lung as the reference,age was identified as a significant risk factor for mild lung injury(OR=1.04,95%CI:1.02-1.06).Age(OR=1.05,95%CI:1.03-1.08)and PSI(OR=6.69,95%CI:2.40-18.66)were found to be risk factors for moderate lung injury,while serum amylase level>110 U/L acted as a protective factor(OR=0.24,95%CI:0.06-0.97).Furthermore,age(OR=1.04,95%CI:1.01-1.07)and PSI(OR=34.86,95%CI:7.03-172.94)were identified as risk factors for severe lung injury,while female gender(OR=0.23;95%CI:0.07-0.78)and a mild pancreatic CT grading(OR=0.09,95%CI:0.01-0.76)were determined to be protective factors for severe lung injury.Conclusion In the evaluation of the severity and progression of lung injury in AP,it is conceivable that the involvement of the perirenal space holds a potentially higher clinical diagnostic value when compared to CT severity indices.
Keywords：acute pancreatitisperirenal spaceacute pancreatitis-associated lung injuryhigh resolution CT
Publication Date：2024-04-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 407-413 )