Yıl: 2017 Cilt: 33 Sayı: 3 Sayfa Aralığı: 153 - 157 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis

Öz:
Objective: The aim of this study was to compare contrast-enhanced computed tomography with diffusion-weighted magnetic resonance imaging in the evaluation of patients with acute biliary pancreatitis.Material and Methods: Fifty-three patients diagnosed with acute biliary pancreatitis, between February 2012 and July 2015, were evaluated using diffusion-weighted magnetic resonance imaging and magnetic resonance cholangiopancreatography to explain the elevation of cholestasis enzymes and bilirubin levels at İstanbul University. Contrast-enhanced computed tomography imaging was applied within 8 h following first evaluation. Demographic data, severity of pancreatitis, pancreatic apparent diffusion coefficient, and computed tomography severity index were compared. The significance of the results was evaluated using Statistical Package for the Social Sciences 21.0 program. Results: Median age was 53.39 years in these 53 patients (26 were males and 27 were females). The mean Ranson criterion was 0.96 and mean hospitalization duration was 16.02 days. Twenty-eight patients were evaluated to have mild acute pancreatitis, whereas 16 were moderately severe and nine were severe based on the Revised Atlanta Classification. Mild pancreatitis score was 0.89, moderately severe pancreatitis score was 3.50, and severe pancreatitis score was 5.78 using the Balthazar score. Elevated C-reactive protein levels were not correlated with necrosis and the clinical severity score (p>0.05). There was no significant difference among the Balthazar score, magnetic resonance cholangiopancreatography-apparent diffusion coefficient score, and Revised Atlanta score in the evaluation of the severity of pancreatitis when the two techniques were compared. A statistically insignificant difference was found between the Balthazar score and magnetic resonance imaging results of clinically confirmed necrosis and non-necrosis patients.Conclusion: It can be concluded that diffusion-weighted magnetic resonance imaging might be better than contrastenhanced computed tomography in the diagnosis of acute pancreatitis as it avoids radiation exposure as well as the development of renal failure and pancreatitis aggravation due to the use of contrast for computed tomography. These results need to be confirmed with randomized prospective controlled studies.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Huang W, Altaf K, Jin T, Xiong J-J, Wen L, Javed MA, et al. Prediction of the severity of acute pancreatitis on admission by urinary trypsinogen activation peptide: A meta-analysis World J Gastroenterol 2013; 19: 4607-4615. [CrossRef]
  • 2. Senthil Kumar P, Ravichandravn P, Jeswanth S. Case matched comparison study of the necrosectomy by retroperitoneal approach with transperitoneal approach for necrotizing pancreatitis in patients with CT severity score of 7 and above. Int J Surg 2012; 10: 587-592. [CrossRef]
  • 3. 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. [CrossRef]
  • 4. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62: 102-111. [CrossRef]
  • 5. Akisik MF, Aisen AM, Sandrasegaran K, Jennings SG, Lin C, Sherman S, et al. Assessment of chronic pancreatitis: Utility of diffusion weighted MR imaging with secretin enhancement. Radiology 2009; 250: 103-109. [CrossRef]
  • 6. Taniguchi T, Kobayashi H, Nishikawa K, Iida E, Michigami Y, Morimoto E, et al. Diffusion-weighted magnetic resonance imaging in autoimmune pancreatitis. Jpn J Radiol 2009; 27: 138-142. [CrossRef]
  • 7. Burdette JH, Elster AD, Ricci PE. Acute cerebral infarction: quantification of spin-density and T2 shine-through phenomena on diffusion-weighted MR images. Radiology 1999; 212: 333-339. [CrossRef]
  • 8. Logue JA, Carter CR. Minimally invasive necrosectomy techniques in severe acute pancreatitis: role of percutaneous necrosectomy and video-assisted retroperitoneal debridement. Gastroenterol Res Pract 2015; 2015: 693040.
  • 9. Larvin M, McMahon MJ. APACHE-II score for assessment and monitoring of acute pancreatitis. Lancet 1989; 2: 201-205. [CrossRef]
  • 10. Petrov MS. Meta-analyses on the prophylactic use of antibiotics in acute pancreatitis: many are called but few are chosen. Am J Gastroenterol 2008; 103: 1837-1838. [CrossRef]
  • 11. Wu BU, Johannes RS, Sun X, Tabak Y, Conwell DL, Banks PA. The early prediction of mortality in acute pancreatitis: a large population-based study. Gut 2008; 57: 1698-1703. [CrossRef]
  • 12. Adam F, Bor C, Uyar M, Demırag K, Çankayalı İ. Severe acute pancreatitis admitted to intensive care unit: SOFA is superior to Ranson's criteria and APACHE II in determining prognosis. Turk J Gastroenterol 2013; 24: 430-435. [CrossRef]
  • 13. Yang YX, Li L. Evaluating the Ability of the Bedside Index for Severity of Acute Pancreatitis Score to Predict Severe Acute Pancreatitis: A Meta-Analysis. Med Princ Pract 2016; 25: 137-142. [CrossRef]
  • 14. Banday IA, Gattoo I, Khan AM, Javeed J, Gupta G, Latief M. Modified Computed Tomography Severity Index for Evaluation of Acute Pancreatitis and its Correlation with Clinical Outcome: A Tertiary Care Hospital Based Observational Study. J Clin Diagn Res 2015; 9: TC01-5. [CrossRef]
  • 15. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013; 62: 102-111. [CrossRef]
  • 16. Trikudanathan G, Attam R, Arain MA, Mallery S, Freeman M.L. Endoscopic interventions for necrotizing pancreatitis. Am. J. Gastroenterol. 2014; 109: 969-981. [CrossRef]
  • 17. Lim E, Sundaraamoorthy RS, Tan D, Teh HS, Tan T-J, Cheng A. Stepup approach and video assisted retroperitoneal debridement in infected necrotizing pancreatitis: A case complicated by retroperitoneal bleeding and colonic fistula. Ann Med Surg (Lond) 2015; 4: 225-229. [CrossRef]
  • 18. Shinya S, Sasaki T, Nakagawa Y, Guiquing Z, Yamamoto F, Yamashita Y. The efficacy of diffusion-weighted imaging for the detection and evaluation of acute pancreatitis. Hepatogastroenterology 2009; 56: 1407-1410.
  • 19. Thomas S, Kayhan A, Lakadamyali H, Oto A. Diffusion MRI of acute pancreatitis and comparison with normal individuals using ADC values. Emerg Radiol 2012; 19: 5-9. [CrossRef]
APA ilhan M, ÜÇÜNCÜ M, GÖK A, ÖNER G, AGOLLİ E, CANBAY B, Bakır B, GÜLOĞLU R, ERTEKİN C (2017). Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. , 153 - 157.
Chicago ilhan Mehmet,ÜÇÜNCÜ Muhammet,GÖK Ali Fuat Kaan,ÖNER Gizem,AGOLLİ Elidor,CANBAY Bahar,Bakır Barış,GÜLOĞLU Recep,ERTEKİN Cemalettin Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. (2017): 153 - 157.
MLA ilhan Mehmet,ÜÇÜNCÜ Muhammet,GÖK Ali Fuat Kaan,ÖNER Gizem,AGOLLİ Elidor,CANBAY Bahar,Bakır Barış,GÜLOĞLU Recep,ERTEKİN Cemalettin Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. , 2017, ss.153 - 157.
AMA ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. . 2017; 153 - 157.
Vancouver ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. . 2017; 153 - 157.
IEEE ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C "Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis." , ss.153 - 157, 2017.
ISNAD ilhan, Mehmet vd. "Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis". (2017), 153-157.
APA ilhan M, ÜÇÜNCÜ M, GÖK A, ÖNER G, AGOLLİ E, CANBAY B, Bakır B, GÜLOĞLU R, ERTEKİN C (2017). Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. Turkish Journal of Surgery, 33(3), 153 - 157.
Chicago ilhan Mehmet,ÜÇÜNCÜ Muhammet,GÖK Ali Fuat Kaan,ÖNER Gizem,AGOLLİ Elidor,CANBAY Bahar,Bakır Barış,GÜLOĞLU Recep,ERTEKİN Cemalettin Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. Turkish Journal of Surgery 33, no.3 (2017): 153 - 157.
MLA ilhan Mehmet,ÜÇÜNCÜ Muhammet,GÖK Ali Fuat Kaan,ÖNER Gizem,AGOLLİ Elidor,CANBAY Bahar,Bakır Barış,GÜLOĞLU Recep,ERTEKİN Cemalettin Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. Turkish Journal of Surgery, vol.33, no.3, 2017, ss.153 - 157.
AMA ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. Turkish Journal of Surgery. 2017; 33(3): 153 - 157.
Vancouver ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis. Turkish Journal of Surgery. 2017; 33(3): 153 - 157.
IEEE ilhan M,ÜÇÜNCÜ M,GÖK A,ÖNER G,AGOLLİ E,CANBAY B,Bakır B,GÜLOĞLU R,ERTEKİN C "Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis." Turkish Journal of Surgery, 33, ss.153 - 157, 2017.
ISNAD ilhan, Mehmet vd. "Comparison of contrast-enhanced CT with diffusion -weighted MRI in the Evaluation of patients with acute biliary pancreatitis". Turkish Journal of Surgery 33/3 (2017), 153-157.