컴퓨터 단층촬영술(computed tomography; CT)은 인의에서 췌장염의 진단 기준으로 이용되고 있으며, Balthazar CT severity index (CTSI)는 CT 영상을 바탕으로 췌장 괴사 부위를 측정하여 췌장염의 심각도를 평가하는 지수이다. 본 연구에서는, 25마리의 비글견을 정상 그룹과 대조군, 자가 담즙 주입을 통해 급성 괴사성 췌장염을 유발한 실험군으로 나누어 Balthazar CTSI 측정 결과와 조직 검사 결과를 비교하였다. 정상 개의 췌장의 Hounsfield unit (HU)은 $52.44{pm}4.58$ 이었고, 급성 괴사성 췌장염에서는 유의적으로 감소하였다(P < .05). 조영 증강 CT 영상에서 확인한 췌장 실질의 괴사 부위를 찾아 Balthazar CTSI를 계산한 결과 조직 검사 결과와 밀접한 상관 관계를 보였으며, 민감도 100%, 특이도 88.89%로 확인되었다. Balthazar CTSI는 급성 췌장염이 발생한 개에서 심각도 평가에 유용한 방법으로 판단된다.
Computed tomography (CT) is considered as gold standard in evaluating pancreatitis in human, but there have been only a few studies in veterinary field. Balthazar CT severity index (CTSI) used to assess the severity of acute necrotizing pancreatitis in human could be applicable to dogs, because the severity of acute pancreatitis depends on the area of pancreatic necrosis in dogs more than in human. In this study, 25 adult, clinically healthy beagle dogs were used. CT examinations was performed in normal pancreas, positive control group and acute necrotizing pancreatitis induced by autologous bile injection. Balthazar CTSI was applied to canine acute necrotizing pancreatitis in contrastenhanced CT image and compared with the result of histopathologic examination. The Hounsfield unit (HU) of normal canine pancreas was $52.44{pm}4.58$ and the density was significantly decreased in acute necrotizing pancreatitis (P < .05). In contrast-enhanced CT examination, pancreatic density was decreased significantly and this area was compatible to pancreatic necrosis. Balthazar CTSI showed positive correlation with histopathologic evaluation with a sensitivity of 100% and a specificity of 88.89%. Balthazar CTSI can be applied to evaluate the severity of acute necrotizing pancreatitis in dogs.
