Perfusion-CT--Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?
| Autor: | Katarzyna Skrobisz-Balandowska, Joanna Pieńkowska, Edyta Szurowska, Katarzyna Gwoździewicz, Justyna Kostro, Iwona Marek, Michał Studniarek |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Physiology Hydrolases lcsh:Medicine Perfusion scanning Blood volume Pathology and Laboratory Medicine Biochemistry Gastroenterology Diagnostic Radiology 030218 nuclear medicine & medical imaging 0302 clinical medicine Blood Flow Medicine and Health Sciences Lipases lcsh:Science Tomography Aged 80 and over Blood Volume Multidisciplinary Pancreatitis Acute Necrotizing Radiology and Imaging Hematology Middle Aged Prognosis Body Fluids Enzymes Blood medicine.anatomical_structure Amylases Physical Sciences Disease Progression Acute pancreatitis Female 030211 gastroenterology & hepatology Radiology Anatomy Pancreas Perfusion Research Article Adult medicine.medical_specialty Imaging Techniques Perfusion Imaging Materials Science Material Properties Ischemia Endocrine System Neuroimaging Gastroenterology and Hepatology Research and Analysis Methods Permeability Necrosis 03 medical and health sciences Exocrine Glands Signs and Symptoms Diagnostic Medicine Internal medicine medicine Humans Aged business.industry lcsh:R Biology and Life Sciences Proteins Lipase Blood flow medicine.disease Computed Axial Tomography Early Diagnosis Pancreatitis Enzymology lcsh:Q Tomography X-Ray Computed business Neuroscience |
| Zdroj: | PLoS ONE, Vol 11, Iss 1, p e0146965 (2016) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Purpose Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. Material and methods 79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4-6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. Results Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. Conclusions CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of developing pancreatic and/or peripancreatic necrosis already on the first day of the onset of symptoms and can be used for treatment planning and monitoring of therapy of acute pancreatitis. Early suspicion of possible pancreatic necrosis both on the basis of scores based on clinical status and laboratory tests have low predictive value. |
| Databáze: | OpenAIRE |
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