ROLE OF MULTIDETECTOR COMPUTED TOMOGRAPHY IN THE CHARACTERISATION OF PANCREATIC LESIONS

Autor: Riya Jeeson, Abishek Balachandran
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Journal of Evidence Based Medicine and Healthcare, Vol 3, Iss 91, Pp 4991-5000 (2016)
ISSN: 2349-2570
2349-2562
Popis: BACKGROUND The aim of this study is to evaluate the role of Multidetector Computed Tomography (MDCT) in evaluation of pancreatic lesions. MATERIALS AND METHODS The study included 50 patients with suspected pancreatic disorders who presented to BMCRI, Bangalore, over a time period from November 2012 to November 2014. All patients underwent noncontrast CT scans using 6-slice MDCT with contrast study as required. The radiological diagnoses were confirmed with biochemical parameters and histopathological correlation. RESULTS Out of 50 patients, 19 were diagnosed with acute pancreatitis, 25 with chronic pancreatitis and 6 with pancreatic neoplasms. 17 of 19 patients (89%) with acute pancreatitis had enlargement of the pancreas and 18 patients (95%) showed peripancreatic inflammatory changes. Hence, focal/diffuse enlargement of pancreas with peripancreatic stranding was found to be the most common finding in mild acute pancreatitis. Pleural effusion and ascites were found to be the most common extrapancreatic complications. Mild pancreatitis was reduced to 5%, moderate and severe pancreatitis increased to 74% and 21%, respectively under the modified CT Severity Index (CTSI) scoring system as compared to CTSI. Few patients categorised as mild pancreatitis in CTSI showed extrapancreatic complications resulting in upgradation to moderate and severe pancreatitis under the Modified CTSI system. Of the 25 cases of chronic pancreatitis, 20 out of 25 patients (80%) showed presence of intraductal and parenchymal calcification, thus found to be the most common CT sign in chronic pancreatitis. Of the 6 patients with pancreatic neoplasms, 4 were pancreatic adenocarcinoma, 1 serous cystadenoma and 1 solid pseudopapillary tumour. Of the 6 cases, 3 were located in the head and uncinate process (50%) with double duct sign noted in these cases. The head and uncinate process was the more common location for pancreatic adenocarcinoma with nonenhancing hypoattenuating lesions being the most common presentation. Peripancreatic infiltration and vascular encasement were seen in 2 patients. Lymphadenopathy and distant metastases were noted in all cases of adenocarcinoma. CONCLUSION MDCT with its faster scanning times, superior resolution and post processing techniques proved to be the imaging modality of choice in imaging pancreatic pathologies and allowing accurate diagnosis.
Databáze: OpenAIRE
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