USG and CT scan evaluation of patients of acute and chronic pancreatitis- a cross-sectional, comparative study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20173591Keywords:
CT Scan, Necrosis, Pancreatitis, Pseudocyst, USGAbstract
Background: Pancreatitis is a condition of inflammation of pancreas with high rate of morbidity and mortality. USG provides the initial radiological assessment of the organ, clue of the extent of involvement and an opportunity to evaluate other abdominal organs. CT scan provides a cross-sectional anatomy of the organ, its internal structure, focal or diffuse involvement and involvement of adjacent structures. This study is done to evaluate the role of USG and CT scan in patients of pancreatitis admitted to Sir Takhtsinhji hospital, government medical college, Bhavnagar, Gujarat, India. Aim was to understand the role of CT and USG in determination of diagnosis of pancreatitis and to highlight and evaluate the cases in which USG failed to diagnose the cases which were helped through by CT.
Methods: This study was done in department of radio diagnosis at Sir Takhtsinhji hospital, government medical college, Bhavnagar, Gujarat, India, over a period of one year from June 2015 to June 2016. Each patient was studied taking into consideration relevant clinical and laboratory factors. USG of patients was done using My Lab 40 or My Lab 20 plus machine. CT scan was done using GE 16 Slice CT scan machine.
Results: Ultrasound by non-invasiveness, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However, USG fails imaging in conditions with excess of bowel gas or fatty patient. It lacks in detailed characterization of the inflammatory process and does not delineate extent of necrosis of the gland. CT is superior to ultrasound for precise detection of size, parenchyma, MPD, calcification, pseudocyst, ascites, pleural effusion, necrosis and peri pancreatic region and hence helps to determine exact extent of inflammation of the organ, multi-system involvement and prognosis.
Conclusions: Ultrasound by non-invasiveness, easy availability, cost parameters, lack of radiation hazard and by ability to demonstrate structural changes in organ is first investigation of choice in pancreatitis. However, ultrasonography lacks in detailed characterization of the extent of involvement of the organ and adjacent structures. CT is superior to ultrasound for precise detection and extension of the pancreatitis and it has better sensitivity and specificity than ultrasonography.
References
Drake R, Vogl AW, Mitchell A.Gray’s anatomy for students. 1st edition. Elsevier. 2004.
Sabiston: Pancreas. Sabiston’s Textbook of Surgery- The Biological Basis of Modern Surgical Practice, Beauchamp, Evers, Mattox 17th edition vol. 2. WB Saunders; 2004.
Haaga JR, Lanzieri CF, Gilkeson RC: The pancreas. In: Haaga JR, ed. Computed Tomography and Magnetic Resonance Imaging of the Whole Body, 4th ed. Philadelphia: Elsevier; 2003:1395-1485.
Rubaum NJ, Shohi T. X-Ray visualisation of the pancreas. From the Department of Surgery, Veteran, Administration Center, and the University of California, Medical Center, Los Angeles, Calif.
Bruno C, Minniti S, Schenal G. The role of ultrasound in acute pancreatitis. Imaging Pancreas. 2009:33-47.
Chaudhary V, Bano S. Imaging of the pancreas: Recent advances. Indian J Endocrinol Metabolism. 2011;15(1):S25-32.
O’Connor OJ, McWilliams S, Maher MM. Imaging of acute pancreatitis. 2011;197:2.
Hessel SJ, Siegelman SS, McNeil BJ, Sanders R, Adams DF, Alderson P, et al. A prospective evaluation of computed tomography and ultrasound of the pancreas. Radiol. 1982;143(1):129-33.
