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Contrast-enhanced ultrasound in the staging of acute pancreatitis

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Abstract

Objective

To determine the diagnostic value of contrast-enhanced ultrasound (CEUS) in the assessment of acute pancreatitis, with computed tomography (CT) as the reference standard.

Methods

Fifty consecutive patients (mean age 58.4 years; range 23–86 years) with acute pancreatitis underwent prospectively both CT and ultrasonography, including CEUS, within a 24-h interval. Pancreatic vascularisation was evaluated with CEUS after injection of a second-generation US contrast-enhancing agent. Acute pancreatitis severity was graded according to the Balthazar index. The results were compared with CT severity index and clinical outcome by using Spearman’s correlation coefficient.

Results

A significant correlation between CT and CEUS was found for the CT severity index (r = 0.926), extent of necrosis (r = 0.893) and Balthazar grade (r = 0.884). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting severe acute pancreatitis based on CT findings (severity index greater than 3 and/or presence of necrosis) were respectively 91%, 100%, 100% and 83%. A significant correlation between CEUS severity index and clinical variables was found: Ranson score (r = 0.442), C-reactive protein (CRP) levels 48 h after admission (r = 0.385) and length of hospital stay (r = 0.362).

Conclusion

CEUS is comparable to CT in detecting pancreatic necrosis as well as predicting its clinical course. Therefore, when CT is contraindicated CEUS may be a valid alternative.

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Authors and Affiliations

  1. Department of Radiology, Hospital Dr. Peset Universitario, 90 Gaspar Aguilar Avenue, 46017, Valencia, Spain

    Tomás Ripollés, María J Martínez, Estela López & Fructuoso Delgado

  2. Department of Gastroenterology, Hospital Virgen de los Lirios, Alcoi, Spain

    Inmaculada Castelló

Authors
  1. Tomás Ripollés
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  2. María J Martínez
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  3. Estela López
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  4. Inmaculada Castelló
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  5. Fructuoso Delgado
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Correspondence to Tomás Ripollés.

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Ripollés, T., Martínez, M.J., López, E. et al. Contrast-enhanced ultrasound in the staging of acute pancreatitis. Eur Radiol 20, 2518–2523 (2010). https://doi.org/10.1007/s00330-010-1824-5

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  • DOI: https://doi.org/10.1007/s00330-010-1824-5

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