EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification

Catalano, Marc F.; Sahai, Anand V.; Levy, Michael J.; Romagnuolo, Joseph; Wiersema, Maurits J.; Brugge, William R.; Freeman, Martin L.; Yamao, Kenji; Canto, Marcia Irene; Hernandez, Lyndon V.

doi:10.1016/j.gie.2008.07.043

Cited by 498 publications

(352 citation statements)

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“…The activation of pancreatic stellate cells produces parenchymal fibrosis and progressive loss of acinar cells and, to a lesser extent, of the islets of Langerhans (1)(2)(3)(4)(5). Endoscopic ultrasound (EUS) has become the technique of choice for the diagnosis of pancreatic disease such as CP, especially in early stages, in which other methods do not achieve the same accuracy (1)(2)(3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

“…The standard classification consists of 9 pancreatic criteria: hyperechoic foci, hyperecoic strands, lobularity, cysts, calcifications, main duct dilation, dilation of the side branches of Wirsung, irregular hyperechoic main pancreatic duct and pancreatic duct walls (3). The hypothesis that all these criteria have the same value for the diagnosis was proposed in the Rosemont classification (4), which defines the EUSbased criteria for CP and their specific validity, establishing different patients groups. However, the interobserver variation of this classification does not improve the aforementioned (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

et al. 2016

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Objective: To determine the accuracy of the acoustic radiation force impulse (ARFI) technique for the diagnosis of chronic pancreatitis. Materials and methods:We present an observational, single-center study that included patients with suspected chronic pancreatitis in the period between October 2012 and September 2015 who underwent endoscopic ultrasound (EUS) and were classified according to the standard and Rosemont criteria. The same group of patients was assessed by the ARFI technology using ACUSON S2000™ equipment with Virtual Touch™ Quantification software for the assessment of pancreatic stiffness by obtaining the shear wave velocity (SWV) in the head, body and tail of the pancreas. Data were analyzed using ANOVA and nonparametric correlation methods. Diagnostic accuracy was obtained by analyzing receiver operating characteristic (ROC) curve.Results: A total of thirty-three patients were studied (45.5% women); mean age was 58.3 ± 11.8 years. Seventeen with a diagnosis of chronic pancreatitis and sixteen classified as normal according to standard criteria. A significant difference was detected between the means of SWV in pancreatic body of patients without (SWV: 1.27 m/s) and with chronic pancreatitis (SWV 1.57 m/s), p = 0.037. The area under the ROC curve was 71.3% (95% CI 0.532-0.895) and the accuracy of ARFI for diagnosing chronic pancreatitis was 69.7% for a SWV of 1.4 m/s in the pancreatic body. The SWV means in head (r = 0.421, p < 0.05) and body (r = 0.455, p < 0.05) of the pancreas showed a significant correlation with the number of EUS criteria for chronic pancreatitis.Conclusion: Quantification of pancreatic stiffness with ARFI elastography technique has proven to be useful for the non-invasive diagnosis of chronic pancreatitis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

et al. 2016

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“…The EUS criteria for chronic pancreatitis, according to Rosemont classification, are listed in Table 1. According to this consensus there are 3 types of results: consistent, suggestive and indeterminate chronic pancreatitis [20]. We included in the study only patients with consistent and suggestive chronic pancreatitis.…”

Section: We Have Conducted the Study At The Gastroenterology Clinic Amentioning

confidence: 99%

The association between chronic pancreatitis and the iNOS-2087A>G polymorphism

Pădureanu

Siloşi

Forţofoiu

et al. 2017

Romanian Journal of Internal Medicine

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Introduction. Chronic pancreatitis is morphologically characterized by ductal dysplasia, breeding grounds for the proliferation of the ductal cells, the degenerative changes in pancreatic acinar cells and fibrosis, and it is defined on the basis of the clinical, morphological and functional criteria.Aim. The aim of our study is to examine the existence of a possible correlation between the iNOS-2087A>G polymorphism and chronic pancreatitis by means of the genetic analysis.Material and method. We have conducted the study at the Gastroenterology Clinic and the Research Center of Gastroenterology and Hepatology of the University of Medicine and Pharmacy, Craiova, between March 2015 – September 2016. The study had a prospective character. Both for the 58 patients diagnosed with chronic pancreatitis and for the 132 patients in the witness group, the biological material was represented by blood, (around 2.5 – 5 milliliters of venous blood) let on EDTA and kept at 4°C up to the separation of the DNA molecule. All the patients were genotyped for the iNOS – 2087A>G polymorphism, by means of the Real Time PCR technique with TaqMan probes.Results. Analysing the prevalence of the iNOS genotypes within the study group and witness group, we have noticed that, statistically speaking, there are no significant differences between the two groups.Conclusion. As a conclusion, in the study lot we can sustain that the risk of developing chronic pancreatitis is not increased by the presence of the iNOS-2087A>G polymorphism.

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“…New directionality of CP diagnosis by EUS was provided in an attempt to improve EUS reliability for CP. This classification system was an attempt to standardize and define more explicitly the endosonographic features and thresholds for the diagnosis of chronic pancreatitis, with grouping of criteria into major and minor importance categories (Tables 1 and 2) [15].…”

Section: New Eus Criteria For Cp Diagnosismentioning

confidence: 99%

“…According to these criteria, early CP is diagnosed by the presence of characteristic imaging findings for early CP together with more than two items among (3)- (6). The characteristic imaging findings for early CP were set as the following seven EUS features (five parenchymal and two ductal features): (1) lobularity with honeycombing, (2) lobularity without honeycombing, (3) hyperechoic foci without shadowing, (4) stranding, (5) cysts, (6) dilated side branches, and (7) hyperechoic main pancreatic duct (MPD) margin [15] (Table 3). More than two among the seven features including any of (1)-(4), which are most likely to reflect fibrous changes in pancreatic parenchyma, are judged to be sufficient for the EUS findings of early CP [9][10][11][12]20,21].…”

Section: Proposed Diagnostic Criteria For Early Stage Cpmentioning

confidence: 99%