caa a22 4500 605493944 CHVBK 20210128100523.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00261-014-0226-6 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0226-6 Perfusion CT: Can it predict the development of pancreatic necrosis in early stage of severe acute pancreatitis? [Elektronische Daten] [Ajay Yadav, Raju Sharma, Devasenathipathy Kandasamy, Ashu Bhalla, Shivanand Gamanagatti, Deep Srivastava, Ashish Upadhyay, Pramod Garg] 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. Springer Science+Business Media New York, 2014 Pancreas nationallicence Perfusion CT nationallicence Severe acute pancreatitis nationallicence Yadav Ajay Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Sharma Raju Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Kandasamy Devasenathipathy Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Bhalla Ashu Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Gamanagatti Shivanand Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Srivastava Deep Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut Upadhyay Ashish Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India aut Garg Pramod Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 488-499 0942-8925 40:3<488 2015 40 261 https://doi.org/10.1007/s00261-014-0226-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0226-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yadav Ajay Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Sharma Raju Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Kandasamy Devasenathipathy Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Bhalla Ashu Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Gamanagatti Shivanand Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Srivastava Deep Department of Radiodiagnosis, All India Institute of Medical Sciences, 110029, New Delhi, India aut NATIONALLICENCE 700 1- Upadhyay Ashish Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 700 1- Garg Pramod Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/3(2015-03-01), 488-499 0942-8925 40:3<488 2015 40 261