Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Background: This study examined the clinical application of the modified computed tomography severity index (MCTSI) and retroperitoneal extension classification (REC) in the evaluation of acute pancreatitis (AP) among Vietnamese patients. Methods: Data from 115 patients with AP between January 2022 and February 2024 were retrospectively analyzed. AP was diagnosed using the revised Atlanta classification (RAC) criteria. All computed tomography images were assessed by two abdominal radiologists with over 10 years of experience. Patients with AP secondary to blunt abdominal trauma were excluded. Results: The mean patient age was 49.8 ± 16.7 years, and the male:female ratio was 2.7:1. Necrotizing AP was observed in 24.3% of cases and extrapancreatic complications in 35.7%. Pancreatic and peripancreatic fluid collections were noted in 68.7% of cases, including 39.1% with acute peripancreatic fluid collection, 7.8% pseudocyst, 21.7% acute necrotic collection, and 4.3% walled-off necrosis. Based on MCTSI, the rates of mild, moderate, and severe AP were 28.7%, 53.9%, and 17.4%, respectively. Grades I, II, III, IV, and V REC represented 55.7%, 13.0%, 19.1%, 5.2%, and 7.0% of patients, respectively. MCTSI and REC were correlated with RAC in the evaluation of AP severity. Multivariate regression analysis revealed MCTSI to be an independent predictor of severe AP (odds ratio, 2.719; 95% confidence interval, 1.149–6.437; P = 0.023). MCTSI > 7 was the cutoff for predicting severe AP, with a sensitivity of 83.3%, specificity of 86.2%, and area under the curve of 0.944 (P < 0.001). Compared to the non-severe group, those with severe AP according to MCTSI had a longer hospitalization period (11 [9.25–16.75] days vs. 9 [6.50–12.00] days), a higher intensive care unit admission rate (30.0% vs. 3.2%), and greater mortality (15.0% vs. 1.1%). Conclusion In the assessment of AP severity, MCTSI and REC were correlated with RAC. MCTSI was an independent predictor of severe AP.

Purpose: To determine the efficacy of apparent diffusion coefficient (ADC) values and ratios (lesion/liver tissue, lesion/splenic tissue, lesion/paraspinal muscle) in differentiating benign from malignant solid liver lesions. Materials and Methods: This study retrospectively analyzed data from 115 patients with solid liver lesions who underwent abdominal magnetic resonance imaging (MRI) at a single institution between January 2023 and December 2024. Lesions were classified as benign or malignant based on biochemical tests as well as radiographic and/or histopathologic findings. ADC values and ratios were determined using a 1.5 T MRI scanner.Quantitative variables are presented as mean ± standard deviation or median (interquartile range). Receiver operating characteristic (ROC) analysis was used to determine the cut-off values for ADC value and ratio, for which associated areas under the ROC curve were calculated. Results: The present analysis included 115 lesions—36 benign and 79 malignant. The median ADC value of the benign lesions was significantly higher than that of malignant lesions: 1744.5 × 10-6 mm2 /s vs. 1168.0 × 10-6 mm2 /s, respectively. The average lesion-toliver ADC (rADC l), lesion-to-spleen ADC (rADCsp), and lesion-to-paraspinal muscle ADC (rADC m) ratios for the benign lesions were significantly higher than those of malignant lesions: 1.79 vs. 1.09, 2.31 vs. 1.44, and 1.19 vs 0.80, respectively. A threshold of 1416 × 10-6 mm2 /s was used to differentiate benign vs. malignant lesions, with a sensitivity of 83.3% and a specificity of 78.5%. The cut-off values for rADC l, rADCsp, and rADC m were 1.55, 1.95, and 0.97, respectively, with sensitivities of 69.4%, 69.4%, and 83.3% and specificities of 87.3%, 91.1%, and 79.9%, respectively. Conclusion ADC metrics obtained from diffusion-weighted MRI effectively distinguished benign from malignant solid liver lesions.