Detectability of pancreas divisum in patients with acute pancreatitis on multi-detector row computed tomography

The purpose of this study was to retrospectively assess the diagnostic performance of multi-detector row computed tomography (MDCT) in an evaluation of pancreas divisum using endoscopic retrograde pancreatography (ERP) as the reference standard. We analyzed 41 consecutive patients (14 cases of pancr...

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Bibliographic Details
Published in:Emergency radiology 2012-04, Vol.19 (2), p.121-125
Main Authors: Asayama, Yoshiki, Fang, Wei, Stolpen, Alan, Kuehn, David
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
Contrast Media
Diagnosis, Differential
Emergency Medicine
Female
Humans
Imaging
Iohexol
Male
Medicine
Medicine & Public Health
Middle Aged
Necrosis
Original Article
Pancreas - abnormalities
Pancreas - diagnostic imaging
Pancreatitis - diagnostic imaging
Radiographic Image Interpretation, Computer-Assisted
Radiology
Retrospective Studies
Tomography, X-Ray Computed - methods
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Summary:The purpose of this study was to retrospectively assess the diagnostic performance of multi-detector row computed tomography (MDCT) in an evaluation of pancreas divisum using endoscopic retrograde pancreatography (ERP) as the reference standard. We analyzed 41 consecutive patients (14 cases of pancreas divisum and 27 cases of standard anatomy) who had undergone both MDCT and ERP for the evaluation of clinically diagnosed acute pancreatitis between November 2004 and June 2007. The CT reconstruction thickness and interval were both 3 mm. Two radiologists independently reviewed CT data, and the diagnostic confidence in determining the pancreatic ductal anatomy was scored using a five-point scale. CT detectability was correlated with the severity of pancreatitis and the degree of pancreatic necrosis based on the Balthazar index. With consensus, 16 of 41 cases (39.0%) were evaluated as indeterminate. Ductal anatomy was correctly diagnosed in 23 of 41 cases (56.1%). Eight of 14 cases (57.1%) were correctly diagnosed as pancreas divisum. Standard anatomy was identified in 15 of 27 cases (55.6%). The inter-observer agreement was substantial ( κ  = 0.71). Grade B or more pancreatitis and the presence of pancreatic necrosis significantly influenced the evaluation of ductal anatomy ( p  = 0.01 and p  
ISSN:1070-3004
1438-1435
DOI:10.1007/s10140-011-1008-x