To investigate the predictive value of multi-slice spiral CT perfusion parameters combined with serum microRNA-92a-3p (miR-92a-3p) and microRNA-361-5p (miR-361-5p) in severe acute pancreatitis.

The medical records of 98 patients with acute pancreatitis admitted to Tongchuan People's Hospital from January 2019 to January 2024 were retrospectively reviewed. According to the severity of the disease, the patients were divided into two groups, 36 patients in the severe group and 62 patients in the mild group, another 40 subjects who underwent physical examination during the same period were selected as the healthy control group. Multi-slice spiral CT perfusion parameters [blood flow, blood volume, mean transit time (MTT), permeability of capillary surface (PS)] and serum miR-92a-3p and miR-361-5p of all subjects were collected, and the differences of parameter indexes among different groups of patients were compared. The receiver operating characteristic (ROC) curve was plotted and the area under the curve (AUC) was calculated to evaluate the predictive value of multi-slice spiral CT perfusion parameters combined with serum miR-92a-3p and miR-361-5p in severe acute pancreatitis.

The PS, miR-92a-3p and miR-361-5p of patients with acute pancreatitis were higher than those of the control group, while the MTT, blood flow and blood volume were lower than those of the control group, with statistically significant differences (P<0.05). The Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, MTT, PS, miR-92a-3p, and miR-361-5p in the severe acute pancreatitis group were higher than those in the mild group, while MTT, blood flow, and blood volume were lower than those in the mild group, with statistically significant differences (P<0.05). Logistic multivariate regression analysis showed that APACHE Ⅱ score ≥29 points, blood flow<62 ml·min^-1·100 mg^-1, blood volume<11 ml/100 mg, MTT<10 s, PS≥47 ml·min^-1·100 mg^-1, miR-92a-3≥2.1, miR-361-5p≥0.54 were all risk factors for predicting severe acute pancreatitis (P<0.05). ROC curve showed that the AUC of the combined APACHE Ⅱ score, blood flow, blood volume, MTT, PS, miR-92a-3 and miR-361-5p in predicting severe acute pancreatitis was 0.831 (95% CI: 0.782-0.912), and the sensitivity and specificity were 85.37% and 86.16%, respectively.

Multi-slice spiral CT perfusion parameters can accurately identify the severity of the disease, the combination of serum miR-92a-3p and miR-361-5p has higher predictive value, providing an important reference for clinical diagnosis and treatment.