Erschienen in:
03.04.2017 | Original Article—Liver, Pancreas, and Biliary Tract
Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis
verfasst von:
Yoshihisa Tsuji, Naoki Takahashi, Hiroyoshi Isoda, Koji Koizumi, Sho Koyasu, Miho Sekimoto, Yuichi Imanaka, Shujiro Yazumi, Masanori Asada, Yoshihiro Nishikawa, Hiroshi Yamamoto, Osamu Kikuchi, Tsukasa Yoshida, Tetsuro Inokuma, Shinji Katsushima, Naoki Esaka, Akihiro Okano, Chiharu Kawanami, Nobuyuki Kakiuchi, Masahiro Shiokawa, Yuzo Kodama, Ichiro Moriyama, Takafumi Kajitani, Yoshikazu Kinoshita, Tsutomu Chiba
Erschienen in:
Journal of Gastroenterology
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Ausgabe 10/2017
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Abstract
Background
Perfusion CT can diagnose pancreatic necrosis in early stage of severe acute pancreatitis, accurately. However, no study to date has examined whether early diagnosis of pancreatic necrosis is useful in predicting persistent organ failure (POF).
Methods
We performed a multi-center prospective observational cohort study to investigate whether perfusion CT can predict the development of POF in the early stage of AP, based on early diagnosis of the development of pancreatic necrosis (PN). From 2009 to 2012, we examined patients showing potential early signs of severe AP (n = 78) on admission. Diagnoses for the development of PN were made prospectively by on-site physicians on the admission based on perfusion CT (diagnosis 1). Blinded retrospective reviews were performed by radiologists A and B, having 8 and 13 years of experience as radiologists (diagnosis 2 and 3), respectively. Positive diagnosis for the development of PN were assumed equivalent to positive predictions for the development of POF. We then calculated the area under the curve (AUC) of the receiver operating characteristic for POF predictions.
Results
Fourteen (17.9%) and 23 patients (29.5%) developed PN and POF, respectively. For diagnoses 1, 2, and 3, AUCs for POF predictions were 74, 68, and 73, respectively.