Acute pancreatitis and computed tomography: Interest of portal venous phase alone in the initial phase.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Acta radiologica Pub Date : 2024-08-01 Epub Date: 2024-06-14 DOI:10.1177/02841851241260874
Wilfried Ansel-Wallois, Parfait Assako, Thierry Yzet, Roger Bouzerar
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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.

急性胰腺炎与计算机断层扫描:最初阶段仅对门静脉阶段感兴趣。
背景:目的:评估在急性胰腺炎(AP)初始阶段进行的单一门静脉期CT与三相CT方案相比对严重程度评估的贡献:在这项回顾性研究中,共纳入了175例急性胰腺炎患者,他们在症状出现后的第3天到第7天之间接受了初始三相CT方案(非对比、动脉相和门静脉相)。AP 严重程度和并发症的分析由两名阅读者使用三种有效的 CT 严重程度评分(CTSI、mCTSI 和 EPIC)进行独立评估。所有评分均适用于三相 CT 方案,并与单门静脉相进行比较。同时还进行了观察者之间的分析:结果:与三相 CT 方案相比,分析单一门静脉阶段后,无论严重程度评分如何,均未观察到明显差异(间质性水肿性胰腺炎:CTSI:2 vs. EPIC:2):CTSI:2 vs. 2,mCTSI:2 vs. 2,EPIC:1 vs. 1;坏死性胰腺炎:CTSI:6 对 6,mCTSI:8 对 8,EPIC:5 对 5)。无论严重程度评分如何,观察者之间的一致性都非常好(ICC = 0.96-0.99):结论:在腹腔镜手术初期进行的三相 CT 方案在评估并发症严重程度方面并不比单一的门静脉方案更好,但可减少 63% 的照射。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
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.
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