Perfusion CT: Can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis?

Yadav, Ajay; Sharma, Raju; Kandasamy, Devasenathipathy; Bhalla, Ashu Seith; Gamanagatti, Shivanand; Srivastava, Deep Narayan; Upadhyay, Ashish Datt; Garg, Pramod Kumar

doi:10.1007/s00261-014-0226-6

Cited by 33 publications

(36 citation statements)

References 39 publications

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“…The ideal time for performing this imaging technique is at least after 72 h after\onset [57,64]. The sensitivity and specificity of perfusion CT for predicting necrotizing pancreatitis was given as 87.5% and 100%, respectively [65]. These data suggest that perfusion CT might be an alternative measure to the clinical scores and CECT for risk stratification in severe AP.…”

Section: Contrast-enhanced Computed Tomographymentioning

confidence: 90%

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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Acute pancreatitis (AP) is a severe inflammation of the pancreas presented with sudden onset and severe abdominal pain with a high morbidity and mortality rate, if accompanied by severe local and systemic complications. Numerous studies have been published about the pathogenesis of AP; however, the precise mechanism behind this pathology remains unclear. Extensive research conducted over the last decades has demonstrated that the first 24 h after symptom onset are critical for the identification of patients who are at risk of developing complications or death. The identification of these subgroups of patients is crucial in order to start an aggressive approach to prevent mortality. In this sense and to avoid unnecessary overtreatment, thereby reducing the financial implications, the proper identification of mild disease is also important and necessary. A large number of multifactorial scoring systems and biochemical markers are described to predict the severity. Despite recent progress in understanding the pathophysiology of AP, more research is needed to enable a faster and more accurate prediction of severe AP. This review provides an overview of the available multifactorial scoring systems and biochemical markers for predicting severe AP with a special focus on their advantages and limitations.

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Section: Contrast-enhanced Computed Tomographymentioning

confidence: 90%

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Silva-Vaz

Abrantes

Castelo‐Branco

et al. 2020

IJMS

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“…This group was fairly large when compared to other studies. Tsuji [ 37 ] evaluated p-CT performed in 30 patients with SAP while Yadav [ 38 ] evaluated 53 patients, including 32 with SAP and 21 with mild acute pancreatitis (MAP). In Delerue study [ 40 ], only 3 patients out of the 54 who had pancreatic perfusion assessment suffered from acute pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

et al. 2016

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PurposeSevere acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis.Material and Methods79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4–6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared.ResultsStatistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests.ConclusionsCT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of developing pancreatic and/or peripancreatic necrosis already on the first day of the onset of symptoms and can be used for treatment planning and monitoring of therapy of acute pancreatitis. Early suspicion of possible pancreatic necrosis both on the basis of scores based on clinical status and laboratory tests have low predictive value.

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“…The sensitivity and specificity of perfusion CT for predicting necrotizing pancreatitis was given with 87.5% and 100%, respectively. 15,16 These data suggest that perfusion CT might be an alternative measure to the clinical scores and CECT for risk stratification in SAP.…”

Section: Current Management Issuesmentioning

confidence: 84%

Acute Pancreatitis—Progress and Challenges

Afghani¹,

Pandol²,

Shimosegawa³

et al. 2015

Pancreas

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An international symposium entitled “Acute pancreatitis: progress and challenges” was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives.

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Perfusion CT: Can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis?

Cited by 33 publications

References 39 publications

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice

Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

Acute Pancreatitis—Progress and Challenges

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