Skip to main content
Erschienen in: Digestive Diseases and Sciences 5/2011

01.05.2011 | Original Article

Can Contrast-Enhanced Ultrasound Evaluate the Severity of Acute Pancreatitis?

verfasst von: Qiang Lu, Yue Zhong, Xiao-rong Wen, Zong-wen Huang, Yu-ting Fan, Qing Xia, Yan Luo

Erschienen in: Digestive Diseases and Sciences | Ausgabe 5/2011

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To investigate the ability of contrast-enhanced ultrasound (CEUS) in the assessment of acute pancreatitis (AP), as well as its diagnostic accuracy in the evaluation of the severity of pancreatitis.

Methods

A prospective double-blind study was carried out in 33 AP patients from May 2007 to January 2008. Each patient underwent both CEUS and contrast-enhanced computed tomography (CECT) with the time interval between two examinations less than 72 h. Using CECT as gold standard, the ability of CEUS to diagnose pancreatic necrosis as well as peripancreatic effusion and/or complications, and its diagnostic value in the evaluation of the severity of pancreatitis, were investigated. Balthazar’s grading system was used to measure CT and ultrasound severity indices (CTSI and USSI), and the correlation between CTSI and USSI was tested by Spearman’s rank correlation coefficient.

Results

A strong correlation between CTSI and USSI was found (r = 0.92, P < 0.01).The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS in the diagnosis of pancreatic parenchyma necrosis were 90, 95, 94, 90 and 95%, in the diagnosis of peripancreatic effusion and/or complications were 83, 100, 93, 100 and 91%, and in the diagnosis of severe pancreatitis were 97, 67, 94, 97 and 67%, respectively.

Conclusions

CEUS has shown to be of clinical value in the assessment of pancreatic necrosis as well as peripancreatic complications in AP and has a high diagnostic accuracy in the evaluation of the severity of pancreatitis. Further studies are needed to add it to the diagnostic algorithm for acute pancreatitis.
Literatur
1.
Zurück zum Zitat Bradley EL III. A clinically based classification system for acute pancreatitis. Ann Chir. 1993;47:537–541.PubMed Bradley EL III. A clinically based classification system for acute pancreatitis. Ann Chir. 1993;47:537–541.PubMed
2.
Zurück zum Zitat Bradley EL III. A clinically based classification system for acute pancreatitis. Summary of the International symposium on acute pancreatitis, Atlanta, Ga, September 11–13, 1992. Arch Surg 1993; 128: 586–590. Bradley EL III. A clinically based classification system for acute pancreatitis. Summary of the International symposium on acute pancreatitis, Atlanta, Ga, September 11–13, 1992. Arch Surg 1993; 128: 586–590.
3.
Zurück zum Zitat Garcea G, Jackson B, Pattenden CJ, et al. Early warning scores predict outcome in acute pancreatitis. J Gastrointest Surg. 2006;10:1008–1015.PubMedCrossRef Garcea G, Jackson B, Pattenden CJ, et al. Early warning scores predict outcome in acute pancreatitis. J Gastrointest Surg. 2006;10:1008–1015.PubMedCrossRef
4.
Zurück zum Zitat Triester SL, Kowdley KV. Prognostic factors in acute pancreatitis. J Clin Gastroenterol. 2002;34:167–176.PubMedCrossRef Triester SL, Kowdley KV. Prognostic factors in acute pancreatitis. J Clin Gastroenterol. 2002;34:167–176.PubMedCrossRef
5.
Zurück zum Zitat Zhang SD. The principle of diagnosis and treatment for severe acute pancreatitis. Chin Surg J. 2001;19:963. Zhang SD. The principle of diagnosis and treatment for severe acute pancreatitis. Chin Surg J. 2001;19:963.
6.
Zurück zum Zitat Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Localio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61:443–451.PubMed Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Localio SA. Objective early identification of severe acute pancreatitis. Am J Gastroenterol. 1974;61:443–451.PubMed
7.
Zurück zum Zitat Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989;2:201–205.PubMedCrossRef Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet. 1989;2:201–205.PubMedCrossRef
8.
Zurück zum Zitat Luo Y, Yuan CX, Peng YL, et al. Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection. World J Gastroenterol. 2001;7:293–295.PubMed Luo Y, Yuan CX, Peng YL, et al. Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection. World J Gastroenterol. 2001;7:293–295.PubMed
9.
Zurück zum Zitat Scholmerich J, Gross V, Johannesson T, et al. Detection of biliary origin of acute pancreatitis. Comparison of laboratory tests, ultrasound, computed tomography, and ERCP. Dig Dis Sci. 1989;34:830–833.PubMedCrossRef Scholmerich J, Gross V, Johannesson T, et al. Detection of biliary origin of acute pancreatitis. Comparison of laboratory tests, ultrasound, computed tomography, and ERCP. Dig Dis Sci. 1989;34:830–833.PubMedCrossRef
10.
Zurück zum Zitat Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331–336.PubMed Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology. 1990;174:331–336.PubMed
11.
Zurück zum Zitat Uhl W, Roggo A, Kirschstein T, et al. Influence of contrast-enhanced computed tomography on course and outcome in patients with acute pancreatitis. Pancreas. 2002;24:191–197.PubMedCrossRef Uhl W, Roggo A, Kirschstein T, et al. Influence of contrast-enhanced computed tomography on course and outcome in patients with acute pancreatitis. Pancreas. 2002;24:191–197.PubMedCrossRef
12.
Zurück zum Zitat Carmona-Sanchez R, Uscanga L, Bezaury-Rivas P, Robles-Diaz G, Suazo-Barahona J, Vargas-Vorackova F. Potential harmful effect of iodinated intravenous contrast medium on the clinical course of mild acute pancreatitis. Arch Surg. 2000;135:1280–1284.PubMedCrossRef Carmona-Sanchez R, Uscanga L, Bezaury-Rivas P, Robles-Diaz G, Suazo-Barahona J, Vargas-Vorackova F. Potential harmful effect of iodinated intravenous contrast medium on the clinical course of mild acute pancreatitis. Arch Surg. 2000;135:1280–1284.PubMedCrossRef
13.
Zurück zum Zitat Arvanitakis M, Delhaye M, De Maertelaere V, et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis. Gastroenterology. 2004;126:715–723.PubMedCrossRef Arvanitakis M, Delhaye M, De Maertelaere V, et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis. Gastroenterology. 2004;126:715–723.PubMedCrossRef
14.
Zurück zum Zitat Burns PN, Wilson SR. Microbubble contrast for radiological imaging: 1. Principles. Ultrasound Q. 2006;22:5–13.PubMed Burns PN, Wilson SR. Microbubble contrast for radiological imaging: 1. Principles. Ultrasound Q. 2006;22:5–13.PubMed
15.
Zurück zum Zitat Wilson SR, Burns PN. Microbubble contrast for radiological imaging: 2. Applications. Ultrasound Q. 2006;22:15–18.PubMed Wilson SR, Burns PN. Microbubble contrast for radiological imaging: 2. Applications. Ultrasound Q. 2006;22:15–18.PubMed
17.
18.
Zurück zum Zitat Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) -update 2008. Ultraschall Med. 2008;29:28–44.PubMedCrossRef Claudon M, Cosgrove D, Albrecht T, et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) -update 2008. Ultraschall Med. 2008;29:28–44.PubMedCrossRef
19.
Zurück zum Zitat Rickes S, Uhle C, Kahl S, et al. Echo enhanced ultrasound: A new valid initial imaging approach for severe acute pancreatitis. Gut. 2006;55:74–78.PubMedCrossRef Rickes S, Uhle C, Kahl S, et al. Echo enhanced ultrasound: A new valid initial imaging approach for severe acute pancreatitis. Gut. 2006;55:74–78.PubMedCrossRef
20.
Zurück zum Zitat Brocchi E, Piscaglia F, Bonora M, et al. Echo-enhanced ultrasonography: Is it the future gold standard of imaging in acute pancreatitis. JOP. 2005;6:464–466.PubMed Brocchi E, Piscaglia F, Bonora M, et al. Echo-enhanced ultrasonography: Is it the future gold standard of imaging in acute pancreatitis. JOP. 2005;6:464–466.PubMed
21.
Zurück zum Zitat Balthazar EJ. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology. 2002;223:603–613.PubMedCrossRef Balthazar EJ. Acute pancreatitis: Assessment of severity with clinical and CT evaluation. Radiology. 2002;223:603–613.PubMedCrossRef
22.
Zurück zum Zitat Manfredi R, Brizi MG, Canade A, Vecchioli A, Marano P. Imaging of acute pancreatitis. Rays. 2001;26:135–142.PubMed Manfredi R, Brizi MG, Canade A, Vecchioli A, Marano P. Imaging of acute pancreatitis. Rays. 2001;26:135–142.PubMed
23.
Zurück zum Zitat Stimac D, Miletic D, Radic M, et al. The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis. Am J Gastroenterol. 2007;102:997–1004.PubMedCrossRef Stimac D, Miletic D, Radic M, et al. The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis. Am J Gastroenterol. 2007;102:997–1004.PubMedCrossRef
24.
Zurück zum Zitat Leen E, Ceccotti P, Kalogeropoulou C, Angerson WJ, Moug SJ, Horgan PG. Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography. AJR Am J Roentgenol. 2006;186:1551–1559.PubMedCrossRef Leen E, Ceccotti P, Kalogeropoulou C, Angerson WJ, Moug SJ, Horgan PG. Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography. AJR Am J Roentgenol. 2006;186:1551–1559.PubMedCrossRef
25.
Zurück zum Zitat Solbiati L, Ierace T, Tonolini M, Cova L. Guidance and control of percutaneous treatments with contrast-enhanced ultrasound. Eur Radiol. 2003;13(Suppl 3):N87–N90.PubMedCrossRef Solbiati L, Ierace T, Tonolini M, Cova L. Guidance and control of percutaneous treatments with contrast-enhanced ultrasound. Eur Radiol. 2003;13(Suppl 3):N87–N90.PubMedCrossRef
26.
Zurück zum Zitat Phillips P, Gardner E. Contrast-agent detection and quantification. Eur Radiol. 2004;14(Suppl 8):P4–P10.PubMed Phillips P, Gardner E. Contrast-agent detection and quantification. Eur Radiol. 2004;14(Suppl 8):P4–P10.PubMed
27.
Zurück zum Zitat Catalano O, Lobianco R, Sandomenico F, Mattace RM, Siani A. Real-time, contrast-enhanced sonographic imaging in emergency radiology. Radiol Med. 2004;108:454–469.PubMed Catalano O, Lobianco R, Sandomenico F, Mattace RM, Siani A. Real-time, contrast-enhanced sonographic imaging in emergency radiology. Radiol Med. 2004;108:454–469.PubMed
28.
Zurück zum Zitat Kwon RS, Scheiman JM. New advances in pancreatic imaging. Curr Opin Gastroenterol. 2006;22:512–519.PubMedCrossRef Kwon RS, Scheiman JM. New advances in pancreatic imaging. Curr Opin Gastroenterol. 2006;22:512–519.PubMedCrossRef
Metadaten
Titel
Can Contrast-Enhanced Ultrasound Evaluate the Severity of Acute Pancreatitis?
verfasst von
Qiang Lu
Yue Zhong
Xiao-rong Wen
Zong-wen Huang
Yu-ting Fan
Qing Xia
Yan Luo
Publikationsdatum
01.05.2011
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 5/2011
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-010-1460-6

Weitere Artikel der Ausgabe 5/2011

Digestive Diseases and Sciences 5/2011 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.