Acute pancreatitis and computed tomography: Interest of portal venous phase alone in the initial phase.
Acta Radiol
; 65(8): 889-897, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38873711
ABSTRACT
BACKGROUND:
There are no guidelines in the literature for the use of a computed tomography (CT) protocol in the initial phase of acute pancreatitis (AP).PURPOSE:
To evaluate the contribution of single portal venous phase CT compared to triple-phase CT protocol, performed in the initial phase of AP for severity assessment. MATERIAL ANDMETHODS:
In this retrospective study, a total of 175 patients with acute pancreatitis who underwent initial triple-phase CT protocol (non-contrast, arterial phase, and portal venous phase) between D3 and D7 after the onset of symptoms were included. Analysis of AP severity and complications was independently assessed by two readers using three validated CT severity scores (CTSI, mCTSI, EPIC). All scores were applied to the triple-phase CT protocol and compared to the single portal venous phase. Inter-observer analyses were also performed.RESULTS:
No significant difference whatever the severity score was observed after analysis of the single portal venous phase compared with the triple-phase CT protocol (interstitial edematous pancreatitis CTSI 2 vs. 2, mCTSI 2 vs. 2, EPIC 1 vs. 1; necrotizing pancreatitis CTSI 6 vs. 6, mCTSI 8 vs. 8, EPIC 5 vs. 5). Inter-observer agreement was excellent (ICC = 0.96-0.99), whatever the severity score.CONCLUSION:
A triple-phase CT protocol performed at the initial phase of AP was no better than a single portal venous for assessing the severity of complications and could lead to a 63% reduction in irradiation.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Pancreatite
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Veia Porta
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Índice de Gravidade de Doença
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Tomografia Computadorizada por Raios X
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Acta Radiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França