CT/MRI Features of Acute Pancreatitis Patients with Different Comorbidity Statuses and Their Correlation with Clinical Outcomes

Purpose: To explore the CT/MRI imaging Features and clinical outcomes of acute pancreatitis (AP) patients with varying comorbidity statuses. Materials and Methods: A retrospective analysis enrolled 277 acute pancreatitis (AP) patients from the Affiliated Hospital of North Sichuan Medical College, with the study period spanning January 2020 to December 2024. Research data collected included clinical profiles, laboratory assay outcomes, radiological imaging results, Cumulative Illness Rating Scale (CIRS) scores, CIRS - comorbidity indices (CIRS - CI), and CIRS - severity indices (CIRS - SI).Patients with comorbidities were stratified by CIRS: mild (1–14 points), moderate (15–18 points), and severe (≥19 points). Imaging features, disease severity, and clinical outcomes were compared across groups, with correlations between comorbidity status, imaging findings, and clinical outcomes analyzed. Results: Among 277 patients, only 2 patients had no comorbidities; 229 were mild, 29 moderate, and 17 severe comorbidities. On CT/MRI images, as the degree of comorbidity increased, the manifestation of AP on images became more severe. Significant differences (P<0.05) can be found in age, CIRS-SI, CIRS-CI, hospital stay duration, BISAP, APACHE II, MCTSI/MMRSI, and EPIC/EPIM scores when comparing patients with different comorbidity statuses. The severe group had higher age, BISAP, EPIC/EPIM, and MCTSI/MMRSI scores vs. mild/moderate groups (P<0.05). CIRS scores positively correlated with all above parameters, Atlanta classification, and clinical outcomes. Conclusion: Different comorbidity statuses have varied CT/MRI characteristics. Comorbidity status show a strong association with AP disease severity, radiological scoring results, and clinical outcomes.Patients with severe comorbidities are older, have higher CT/MRI scores, more severe disease, longer hospital stays, and poorer prognoses.