Abstract：Objective: To analyze the correlation between Balthazar CT grading and contrast-enhanced CT (CECT) necrosis volume and attenuation value and prognosis of patients with acute necrotizing pancreatitis. Methods: 92 patients with acute necrotizing pancreatitis who were treated in the hospital were selected between June 2019 and June 2021, and they were divided into the poor prognosis group and the good prognosis group according to the clinical prognosis at 6 months of follow-up. The general data of the two groups of patients were collected, and Balthazar CT, CECT necrosis volume and attenuation value were compared between the two groups. Multivariate logistic regression analysis was used to analyze the influencing factors of prognosis in patients with acute necrotizing pancreatitis. Receiver operating characteristic curve (ROC) was adopted to analyze the predictive value of Balthazar CT grading, CECT necrosis volume and attenuation value on prognosis in patients with acute necrotizing pancreatitis. Results: At 6 months of follow-up, there were 64 cases of poor prognosis and 28 cases of good prognosis among 92 patients with acute necrotizing pancreatitis. There were no significant differences in age, gender, body mass index, onset time, etiology, comorbidities, amylase (AMS) and albumin (ALB) between the two groups (P>0. 05). The APACHE Ⅱ score, C-reactive protein (CRP), blood urea nitrogen, Balthazar CT, necrosis volume and average attenuation value in the poor prognosis group were significantly higher than those in the good prognosis group (P<0. 05). Logistics analysis showed that Balthazar CT grading, necrosis volume and average attenuation value were independent risk factors for poor prognosis in patients with acute necrotizing pancreatitis (P<0. 05). The areas under the curves (AUCs) of Balthazar CT grading, necrosis volume and average attenuation value on predicting the prognosis of patients with acute necrotizing pancreatitis were 0. 765, 0. 624, 0. 764 and 0. 861 respectively. Conclusion: The Balthazar CT grading, necrosis volume and average attenuation value are significantly higher among patients with acute necrotizing pancreatitis complicated with poor prognosis, and they are also independent risk factors for poor prognosis , and can help clinically predict the prognosis of patients with acute necrotizing pancreatitis, and the combined detection has better application effects.
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2022, Vol. 28 
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