caa a22 4500 605495467 CHVBK 20210128100531.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00261-014-0210-1 doi (NATIONALLICENCE)springer-10.1007/s00261-014-0210-1 Use of CT and MRI in emergency department patients with acute pancreatitis [Elektronische Daten] [Atul Shinagare, Ivan Ip, Ali Raja, V. Sahni, Peter Banks, Ramin Khorasani] Purpose: Assess the utility of CT and MRI in patients with acute pancreatitis (AP) presenting to emergency department (ED). Materials and Methods: In this Institutional Review Board-approved retrospective study, we identified all patients with AP from March 2012 through February 2013 in ED of a teaching hospital with approximately 60,000 annual visits. Patients were initially identified via ICD-9 code for AP (577.0); diagnosis was confirmed by chart review using established diagnostic criteria (presence of two of the following: typical abdominal pain, elevated lipase/amylase>3 times normal, or imaging findings of pancreatitis). Abdominal CT or MRI obtained in the ED and within 24h of admission was reviewed by a fellowship-trained abdominal radiologist. Results: Of 101 patients admitted with AP (60 women, 41 men; mean age 52years, range 20-89), 63 (62.4%) underwent imaging; only one (1.6%) showed pancreatic necrosis. 88 (87.1%) patients could have been clinically diagnosed without imaging based on presence of abdominal pain and elevated laboratory values; 13 (12.9%) required imaging for diagnosis. Of 88 patients who met AP diagnostic criteria without imaging, 50 (56.8%) nonetheless underwent imaging, with AP without necrosis seen in 34 (68.0%), pancreatic necrosis in one (2.0%), sequelae of prior AP in four (8.0%), and no abnormality in 11 (22.0%). Conclusion: Early imaging is common in patients with AP, even when the diagnosis can be established based on non-imaging criteria, rarely demonstrating pancreatic necrosis. Reducing overuse of early imaging in patients with confident diagnosis of AP may improve quality and reduce waste. Springer Science+Business Media New York, 2014 Acute pancreatitis nationallicence Emergency department nationallicence CT nationallicence MRI nationallicence Diagnostic criteria nationallicence Shinagare Atul Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Ip Ivan Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Raja Ali Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Sahni V. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Banks Peter Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Khorasani Ramin Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 272-277 0942-8925 40:2<272 2015 40 261 https://doi.org/10.1007/s00261-014-0210-1 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/s00261-014-0210-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shinagare Atul Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 700 1- Ip Ivan Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 700 1- Raja Ali Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 700 1- Sahni V. Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 700 1- Banks Peter Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 700 1- Khorasani Ramin Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, 02115, Boston, MA, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 272-277 0942-8925 40:2<272 2015 40 261