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

Verfasser / Beitragende:
[Ajay Yadav, Raju Sharma, Devasenathipathy Kandasamy, Ashu Bhalla, Shivanand Gamanagatti, Deep Srivastava, Ashish Upadhyay, Pramod Garg]
Ort, Verlag, Jahr:
2015
Enthalten in:
Abdominal Imaging, 40/3(2015-03-01), 488-499
Format:
Artikel (online)
ID: 605493944
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024 7 0 |a 10.1007/s00261-014-0226-6  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00261-014-0226-6 
245 0 0 |a Perfusion CT: Can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis?  |h [Elektronische Daten]  |c [Ajay Yadav, Raju Sharma, Devasenathipathy Kandasamy, Ashu Bhalla, Shivanand Gamanagatti, Deep Srivastava, Ashish Upadhyay, Pramod Garg] 
520 3 |a Purpose: Pancreatic necrosis is an important determinant of patient outcome in severe acute pancreatitis (SAP). This prospective study was conducted to evaluate if perfusion CT (PCT) can predict the development of necrosis at an early stage in SAP. Methods: PCT was performed within 72h of abdominal pain in 57 consecutive admitted patients of acute pancreatitis, out of which four patients were excluded. Thirty-two patients were classified as SAP and 21 as mild acute pancreatitis (MAP) on the basis of APACHE II or SIRS criteria or presence of organ failure. All patients underwent a follow-up CECT at 3weeks to look for pancreatic necrosis. Results: Out of 32 patients of SAP, 14 patients showed perfusion defects. The mean blood flow (BF) in these areas was 11.47±5.56mL/100mL/min and median blood volume (BV) was 3.92mL/100mL (0.5-8.49mL/100mL). All these patients developed necrosis on follow-up scan. Two patients who did not show perfusion defects also developed necrosis. Remaining 37 patients (16 SAP and 21 MAP) did not show perfusion defect and did not develop necrosis on follow-up. All regions showing BF less than ≤23.45mL/100mL/min and BV ≤8.49mL/100mL developed pancreatic necrosis. The values of perfusion parameters may vary with the scanner, mathematical model and protocol used. The sensitivity and specificity of PCT for predicting pancreatic necrosis were 87.5% and 100%, respectively. The cut off values of BF and BV for predicting the development of pancreatic necrosis were 27.29mL/100mL/min and 8.96mL/100mL, respectively, based on ROC curve. Summary: PCT is a reliable tool for early prediction of pancreatic necrosis, which may open new avenues to prevent this ominous complication. 
540 |a Springer Science+Business Media New York, 2014 
690 7 |a Pancreas  |2 nationallicence 
690 7 |a Perfusion CT  |2 nationallicence 
690 7 |a Severe acute pancreatitis  |2 nationallicence 
700 1 |a Yadav  |D Ajay  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Sharma  |D Raju  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Kandasamy  |D Devasenathipathy  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Bhalla  |D Ashu  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Gamanagatti  |D Shivanand  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Srivastava  |D Deep  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
700 1 |a Upadhyay  |D Ashish  |u Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India  |4 aut 
700 1 |a Garg  |D Pramod  |u Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India  |4 aut 
773 0 |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/3(2015-03-01), 488-499  |x 0942-8925  |q 40:3<488  |1 2015  |2 40  |o 261 
856 4 0 |u https://doi.org/10.1007/s00261-014-0226-6  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00261-014-0226-6  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yadav  |D Ajay  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Sharma  |D Raju  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kandasamy  |D Devasenathipathy  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bhalla  |D Ashu  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Gamanagatti  |D Shivanand  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Srivastava  |D Deep  |u Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Upadhyay  |D Ashish  |u Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Garg  |D Pramod  |u Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Abdominal Imaging  |d Springer US; http://www.springer-ny.com  |g 40/3(2015-03-01), 488-499  |x 0942-8925  |q 40:3<488  |1 2015  |2 40  |o 261