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[Dynamic high-contrast computed tomography in the diagnosis of pancreatic necrosis]
F Campos-Campos1, E A Ayala-López, A Velázquez-García
1Servicio de Cirugia General, Hospital de Especialidades Centro Médico La Raza, Instituto Mexicano del Seguro Social, México, D. F.
Unlabelled:
This work intended to find out whether dynamic high-contrast computed axial tomography (CAT scan) in effective and more useful than conventional computed tomography for the diagnosis of pancreatic necrosis in patients with severe acute pancreatitis.
Background:
Although many methods have been used to predict the severity and extent of pancreatic necrosis, few studies have assessed computed tomography.
Methods:
Longitudinal, prospective and comparative study was performed on consecutive patients with severe acute pancreatitis in which dynamic high-contrast computed tomography and conventional computed tomography were carried out.
Results:
In pancreatic necrosis, pancreatic densities were lower. Necrosis by itself was also associated with higher severity scores, but not with a higher mortality rate. However, mortality rates were influenced by the extent of pancreatic necrosis. Sensitivity of 100%, specificity of 68%, positive predictive and negative predictive values of 100 and 42% were achieved.
Statistics:
Densities of TCNL and TCAC were analyzed using student's t test of independent samples. The correlation of the aorta/pancreas index and the presence of necrosis was analyzed using a linear correlation test.
Conclusions:
The authors conclude that dynamic high-contrast computed tomography is more effective than conventional computed tomography in diagnosing pancreatic necrosis. Moreover, the diagnosis of pancreatic necrosis and its extent makes it possible to formulate a prognosis as to severity of the disease.