Wilfried Ansel-Wallois, Parfait Assako, Thierry Yzet, Roger Bouzerar
{"title":"Acute pancreatitis and computed tomography: Interest of portal venous phase alone in the initial phase.","authors":"Wilfried Ansel-Wallois, Parfait Assako, Thierry Yzet, Roger Bouzerar","doi":"10.1177/02841851241260874","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There are no guidelines in the literature for the use of a computed tomography (CT) protocol in the initial phase of acute pancreatitis (AP).</p><p><strong>Purpose: </strong>To evaluate the contribution of single portal venous phase CT compared to triple-phase CT protocol, performed in the initial phase of AP for severity assessment.</p><p><strong>Material and methods: </strong>In this retrospective study, a total of 175 patients with acute pancreatitis who underwent initial triple-phase CT protocol (non-contrast, arterial phase, and portal venous phase) between D3 and D7 after the onset of symptoms were included. Analysis of AP severity and complications was independently assessed by two readers using three validated CT severity scores (CTSI, mCTSI, EPIC). All scores were applied to the triple-phase CT protocol and compared to the single portal venous phase. Inter-observer analyses were also performed.</p><p><strong>Results: </strong>No significant difference whatever the severity score was observed after analysis of the single portal venous phase compared with the triple-phase CT protocol (interstitial edematous pancreatitis: CTSI: 2 vs. 2, mCTSI: 2 vs. 2, EPIC: 1 vs. 1; necrotizing pancreatitis: CTSI: 6 vs. 6, mCTSI: 8 vs. 8, EPIC: 5 vs. 5). Inter-observer agreement was excellent (ICC = 0.96-0.99), whatever the severity score.</p><p><strong>Conclusion: </strong>A triple-phase CT protocol performed at the initial phase of AP was no better than a single portal venous for assessing the severity of complications and could lead to a 63% reduction in irradiation.</p>","PeriodicalId":7143,"journal":{"name":"Acta radiologica","volume":" ","pages":"889-897"},"PeriodicalIF":1.1000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta radiologica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/02841851241260874","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: There are no guidelines in the literature for the use of a computed tomography (CT) protocol in the initial phase of acute pancreatitis (AP).
Purpose: To evaluate the contribution of single portal venous phase CT compared to triple-phase CT protocol, performed in the initial phase of AP for severity assessment.
Material and methods: In this retrospective study, a total of 175 patients with acute pancreatitis who underwent initial triple-phase CT protocol (non-contrast, arterial phase, and portal venous phase) between D3 and D7 after the onset of symptoms were included. Analysis of AP severity and complications was independently assessed by two readers using three validated CT severity scores (CTSI, mCTSI, EPIC). All scores were applied to the triple-phase CT protocol and compared to the single portal venous phase. Inter-observer analyses were also performed.
Results: No significant difference whatever the severity score was observed after analysis of the single portal venous phase compared with the triple-phase CT protocol (interstitial edematous pancreatitis: CTSI: 2 vs. 2, mCTSI: 2 vs. 2, EPIC: 1 vs. 1; necrotizing pancreatitis: CTSI: 6 vs. 6, mCTSI: 8 vs. 8, EPIC: 5 vs. 5). Inter-observer agreement was excellent (ICC = 0.96-0.99), whatever the severity score.
Conclusion: A triple-phase CT protocol performed at the initial phase of AP was no better than a single portal venous for assessing the severity of complications and could lead to a 63% reduction in irradiation.
期刊介绍:
Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.