Role of multi-detector computed tomography in severity assessment of cases of acute pancreatitis

Saneesh, P S; Garga, Umesh Chandra; Gupta, Arun Kumar; Yelamanchi, Raghav

doi:10.1007/s00508-021-01870-7

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…The mortality and morbidity of acute pancreatitis are high, especially in patients with severe variants. The in ammatory process of acute pancreatitis is essentially self-driven auto-dyspepsia caused by inappropriate activation of pancreatic progenase [10]. Gallstones and alcoholism are the two most common causes of acute pancreatitis [11].…”

Section: Discussionmentioning

confidence: 99%

Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue

Lv,

Zhou,

Ding

et al. 2023

Preprint

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Objective: Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue. Methods: 97 patients with suspected severe pancreatitis who were examined in our hospital and inpatient department between July 2019 and July 2021 were selected as the study subjects. All patients underwent multilayer spiral CT enhancement and ultrasound scans in a stable condition. The pictorial characteristics of multi-slice spiral CT enhancement and ultrasound scan in two groups of patients with acute severe pancreatitis were observed and recorded, the diagnostic value of multi-slice spiral CT enhanced scan and combined ultrasound diagnosis of acute severe pancreatitis and pathological examination results, and the diagnostic value of multi-slice spiral CT enhanced scan and joint ultrasound for the diagnosis of acute severe pancreatitis. Results: Multi-layer spiral CT (MSCT) enhanced scan showed local or diffuse cell enlargement of the pancreas and inflammatory cell changes in the peripaniatic fat connective tissue. Inflammatory changes in the peripaniatic adipate connective tissue, intra-parenchymal or peripancreatic effusion of the pancreas, including pancreatic and fat necrosis, pancreatic abscesses. Different degrees of localized or diffuse weak or no reinforced low-density necrosis areas are visible in the parenchyma of the pancreas. The pancreas is significantly enlarged, especially in the tail of the pancreas, and a small amount of exudation is seen around the pancreas; ultrasound image features: the echo of the pancreas parenchyma is uniform or unevenly weakened, manifested by edema or hemorrhagic necrosis. Clinical examination of the lesion confirmed that 61 patients were affected with Severe acute pancreatitis(SAP), and 33 cases were negative patients. Taking the pathological examination results as the gold standard, 65 patients were diagnosed with multi-slice spiral CT enhanced scan and 60 cases were diagnosed with joint diagnosis; the sensitivity of joint detection (93.44%) was significantly higher than that of multilayer spiral CT enhanced scan (88.52%); the specificity of joint detection (90.91%) was higher than that of multilayer spiral CT enhanced scan (78.79%); and the accuracy of joint detection (92.55%) was higher than that of multilayer spiral CT enhanced scan (85.11%). The diagnostic value of contrast-enhanced ultrasound (CEUS) combined with multi-slice helical CT (MSCT) for tongue cancer and its lymph node metastasis (LNM) has also been assessed. Conclusion: Multi-layer spiral CT enhanced scanning combined with ultrasonography can help diagnose in patients with diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue., improve accuracy, sensitivity and specificity, and then improve the clinical diagnostic value.

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Section: Discussionmentioning

confidence: 99%

Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue

Lv,

Zhou,

Ding

et al. 2023

Preprint

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“…CECT images show the presence of necrosis as single or multiple regions of nonenhancing pancreatic parenchyma in ANP patients [7]. Additionally, multislice CECT scans are beneficial for identifying the complications of AP due to its value in disease diagnosis and severity grading [21]. Recently, the advance of DECT with iodine quantification allows differentiation of normal pancreatic parenchyma from inflammatory pancreatic parenchyma and exerts superior sensitivity for diagnosing early AP compared to standard imaging methods [22].…”

Section: Discussionmentioning

confidence: 99%

Feasibility of using software-aided selection of virtual monoenergetic level for optimal image quality of acute necrotising pancreatitis based on dual-energy computed tomography: a preliminary study

et al. 2023

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Objective This study aimed to assess the feasibility of software-aided selection of monoenergetic level for acute necrotising pancreatitis (ANP) depiction compared to other automatic image series generated using dual-energy computed tomography (CT). Methods The contrast-enhanced dual-source dual-energy CT images in the portal venous phase of 48 patients with ANP were retrospectively analysed. Contrast-to-noise ratio (CNR) of pancreatic parenchyma-to-necrosis, signal-to-noise ratio (SNR) of the pancreas, image noise, and score of subjective diagnosis were measured, calculated, and compared among the CT images of 100 kV, Sn140 kV, weighted-average 120 kV, and optimal single-energy level for CNR. Results CNR of pancreatic parenchyma-to-necrosis in the images of 100 kV, Sn140 kV, weighted-average 120 kV, and the optimal single-energy level for CNR was 5.18 ± 2.39, 3.13 ± 1.35, 5.69 ± 2.35, and 9.99 ± 5.86, respectively; SNR of the pancreas in each group was 6.31 ± 2.77, 4.27 ± 1.56, 7.21 ± 2.69, and 11.83 ± 6.30, respectively; image noise in each group was 18.78 ± 5.20, 17.79 ± 4.63, 13.28 ± 3.13, and 9.31 ± 2.96, respectively; and score of subjective diagnosis in each group was 3.56 ± 0.50, 3.00 ± 0.55, 3.48 ± 0.55, and 3.88 ± 0.33, respectively. The four measurements of the optimal single-energy level for CNR images were significantly different from those of images in the other three groups (P < 0.05). CNR of pancreatic parenchyma-to-necrosis, SNR of the pancreas, and score of subjective diagnosis in the images of the optimal single-energy level for CNR were significantly higher, while the image noise was lower than those in the other three groups (all P = 0.000). Conclusion Optimal single-energy level imaging for CNR of dual-source CT could improve quality of CT images in patients with ANP, enhancing the display of necrosis in the pancreas.

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“…All patients were admitted within 24 h after the onset of SAP. The inclusion criteria for eligible patients were as follows: 1) Elderly patients aged 60 years and above; 2) Diagnosed with acute pancreatitis according to the “Guidelines for the Diagnosis and Treatment of Acute Pancreatitis”, confirmed by imaging examinations such as abdominal ultrasound and abdominal CT scans, as well as laboratory tests including blood amylase and serum lipase, and accompanied by persistent (> 48 h) organ dysfunction [ 11 ]; 3) Patients who underwent MSCT perfusion imaging examination; 4) Patients with necessary data available. Exclusion criteria included: 1) Patients with trauma; 2) Patients who had undergone pancreatic surgery; 3) Patients who voluntarily gave up diagnosis and treatment; 4) Transferred patients; 5) Patients with other acute or chronic diseases such as malignant tumors, cardiovascular diseases.…”

Section: Methodsmentioning

confidence: 99%

A Comprehensive Study on the Diagnostic Value of Multi-Slice Computed Tomography for Peripancreatic Infection in Elderly With Severe Acute Pancreatitis

Hao,

Sun,

2024

Gastroenterol Res

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Background This study investigated the diagnostic efficacy of multi-slice spiral computed tomography (MSCT) perfusion imaging in evaluating peripancreatic infection in elderly patients with severe acute pancreatitis (SAP). Methods A retrospective analysis was conducted on the clinical data of 110 elderly SAP patients treated at our hospital from March 2018 to August 2019. The study correlated MSCT perfusion imaging characteristics with peripancreatic infection in elderly SAP patients. Additionally, receiver operating characteristic (ROC) curves were constructed to assess the diagnostic performance of MSCT perfusion imaging parameters in evaluating peripancreatic infection in elderly SAP patients. Results The results indicated that among all 110 elderly SAP patients, the incidence rate of peripancreatic infection was 20.91%, with a mortality rate of 0.91%. MSCT perfusion imaging revealed that after peripancreatic infection in elderly SAP patients, there was a decrease in pancreatic density, local enlargement of the pancreas, blurring of the pancreatic margins, and associated ascites. Compression/narrowing/occlusion of the splenic vein was observed in 22 patients, compression/narrowing/occlusion of the superior mesenteric vein in 17 patients, thickening/thrombosis of the portal vein in 19 patients, and collateral circulation in 21 patients. Compared to elderly SAP patients without peripancreatic infection, those with the infection showed prolonged peak times, reduced peak heights, and decreased blood flow. ROC analysis indicated that the combination of the three parameters (peak time, peak height, and blood flow) had higher specificity and area under the curve (AUC) than single parameters, with no significant difference in sensitivity between the combination and single parameters. Conclusions In conclusion, combining the three key MSCT perfusion imaging parameters (peak time, peak height, and blood flow) can significantly enhance the predictive efficacy for the risk of peripancreatic infection in elderly SAP patients.

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Role of multi-detector computed tomography in severity assessment of cases of acute pancreatitis

Cited by 7 publications

References 18 publications

Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue

Combination diagnostic approach of multilayer spiral CT enhanced scan and ultrasound in diffuse cell enlargement of the pancreas and inflammatory cell alterations in the peripancreatic fat connective tissue

Feasibility of using software-aided selection of virtual monoenergetic level for optimal image quality of acute necrotising pancreatitis based on dual-energy computed tomography: a preliminary study

A Comprehensive Study on the Diagnostic Value of Multi-Slice Computed Tomography for Peripancreatic Infection in Elderly With Severe Acute Pancreatitis

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