Dynamic high-contrast computed tomography in the diagnosis of pancreatic necrosis
Campos-Campos, F.; Ayala-López, E.A.; Velázquez-García, A.
Revista de Gastroenterologia de Mexico 60(3): 149-153
1995
ISSN/ISBN: 0375-0906 PMID: 7481448 Document Number: 442486
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. Although many methods have been used to predict the severity and extent of pancreatic necrosis, few studies have assessed computed tomography. 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. 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. 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. 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.