Standard criteria versus Rosemont classification for EUS-diagnosis of chronic pancreatitis

Abstract

Aim: to study the possible differences in the final diagnosis of chronic pancreatitis by using standard classification described by Wiersema et al. and the new classification proposed recently by Rosemont.Material and methods: forty-seven patients with the diagnosis of chronic pancreatitis were included in this study. The parenchymal and ductal criteria were studied, the patients were divided in two groups for Wiersema criteria: < 4 criteria, non-diagnostic for chronic pancreatitis and ≥ 4 criteria, diagnosis of chronic pancreatitis. The same patients were divided in four groups according to Rosemont classification: normal pancreas, indeterminate, suggestive and consistent with chronic pancreatitis. We analyzed these data with Chi-square test reported with 95% confidence intervals (CI).Results: in patients with chronic pancreatitis the most frequent criteria observed were lobularity in 66% of cases and pancreatic duct dilatation and calcifications in 57.4% of cases each. We found a significant statistical association between the results of both classifications (p < 0.05). The highest association is found in patients with more than 4 standard criteria and definitive diagnostic of chronic pancreatitis according to Rosemont classification. In patients who have less than 4 standard criteria the diagnosis is suggestive of chronic pancreatitis by using the Rosemont classification in 27.66% (p < 0.05).Conclusion: these results show that no significant statistical differences are found for patients with > 4 criteria diagnosis by standard criteria. But 27.66% patients with less than 4 standard criteria would be suggestive according to Rosemont classification (p < 0.05). Hence, the new classification would be useful in patients with high suspicion of chronic pancreatitis with < 4 standard criteria but with more significance such as parenchymal lithiasis, lobularity or ductal calcifications.

Endoscopic ultrasound‐based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis

“…Several studies on the accuracy of EUS criteria for the diagnosis of CP have been reported 27–30 . The higher the number of detected criteria is, the higher is the specificity and positive predictive value of the EUS finding.…”

Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain

“…The EUS was performed by an expert endoscopist. The Rosemont criteria were used for diagnosis of chronic pancreatitis …”

“…The Rosemont criteria were used for diagnosis of chronic pancreatitis. 15 Statistical analyses. A priori, we calculated a sample of 50 individuals will limit the width of the 95% confidence interval to ± 5% if the estimated prevalence of PEI (H1) and chronic pancreatitis (H3) are both 10%.…”

Los criterios de Rosemont en ultrasonografía endoscópica: ¿son predictores de insuficiencia pancreática exocrina?

“…2,3 La ultrasonografía endoscópica (USE) es en la actualidad el método de elección para la detección de cambios morfológicos tempranos relacionados a PC, debido a su capacidad para detectar cambios menores parenquimatosos y ductales, que no pueden ser detectados por otros métodos de imágenes, y su especificidad aumenta con el aumento de los criterios diagnósticos. 4 Para el diagnóstico por USE de PC, los criterios de Rosemont modificados son los más utilizados. La clasificación de Rosemont se compone de criterios mayores y menores bien definidos y cuatro grupos de diagnóstico.…”