HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Casas, J. D. Articles by Cuadras, P. Search for Related Content PubMed PubMed Citation Articles by Casas, J. D. Articles by Cuadras, P. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Prognostic Value of CT in the Early Assessment of Patients with Acute Pancreatitis

¹ All authors: Department of Radiology, Autonomous University of Barcelona, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona E-08916, Spain.

OBJECTIVE. This study investigates the prognostic value of early CT in acute pancreatitis, the role of pancreatic necrosis as a indicator of prognosis, and the need for the routine use of IV iodinated contrast material in early CT to assess prognosis in these patients.

MATERIALS AND METHODS. We conducted a retrospective review of 148 patients who underwent unenhanced and contrast-enhanced helical CT within 72 hr after onset of symptoms of a first episode of acute pancreatitis. Patients were classified by CT grade and grouped into two categories (mild: grades A, B, C; and severe: grades D and E) that were correlated with complications and death. In the grades including patients with pancreatic necrosis, it was also correlated with complications and death.

RESULTS. All complications (n = 15) and deaths (n = 4) occurred in patients with a CT grade of severe disease; differences as compared with mild grade were significant (p < 0.001 and p < 0.03, respectively). CT grade had a sensitivity and specificity of 100% and 61.6%, respectively, for predicting morbidity and 100% and 56.9% for predicting mortality. The 13 patients with necrosis were all in the severe group (p < 0.001). Necrosis detection on early CT had a sensitivity and specificity of 53.3% and 90.2%, respectively, for predicting morbidity and 75% and 83.8% for mortality.

CONCLUSION. Early unenhanced CT alone was a good indicator of severity of acute pancreatitis in our selected population. CT grade was sensitive for predicting outcome in acute pancreatitis. Pancreatic necrosis, estimated on early, contrast-enhanced CT and seen only in patients having severe disease, was a specific predictor of morbidity and mortality. These findings lead us to suggest that the use of iodinated contrast material to assess necrosis can be reserved for only those patients classified as having severe disease on unenhanced CT.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K. Sandrasegaran, M. Tann, S. G. Jennings, D. D. Maglinte, S. D. Peter, S. Sherman, and T. J. Howard Disconnection of the Pancreatic Duct: An Important But Overlooked Complication of Severe Acute Pancreatitis RadioGraphics, September 1, 2007; 27(5): 1389 - 1400. [Abstract] [Full Text] [PDF]

				C Messiou and A G Chalmers Imaging in acute pancreatitis Imaging, September 1, 2004; 16(4): 314 - 322. [Abstract] [Full Text] [PDF]