Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis

Yoshihisa Tsuji, Naoki M Takahashi, Hiroyoshi Isoda, Koji Koizumi, Sho Koyasu, Miho Sekimoto, Yuichi Imanaka, Shujiro Yazumi, Masanori Asada, Yoshihiro Nishikawa, Hiroshi Yamamoto, Osamu Kikuchi, Tsukasa Yoshida, Tetsuro Inokuma, Shinji Katsushima, Naoki Esaka, Akihiro Okano, Chiharu Kawanami, Nobuyuki Kakiuchi, Masahiro ShiokawaYuzo Kodama, Ichiro Moriyama, Takafumi Kajitani, Yoshikazu Kinoshita, Tsutomu Chiba

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

BACKGROUND: Perfusion CT can diagnose pancreatic necrosis in early stage of severe acute pancreatitis, accurately. However, no study to date has examined whether early diagnosis of pancreatic necrosis is useful in predicting persistent organ failure (POF). METHODS: We performed a multi-center prospective observational cohort study to investigate whether perfusion CT can predict the development of POF in the early stage of AP, based on early diagnosis of the development of pancreatic necrosis (PN). From 2009 to 2012, we examined patients showing potential early signs of severe AP (n = 78) on admission. Diagnoses for the development of PN were made prospectively by on-site physicians on the admission based on perfusion CT (diagnosis 1). Blinded retrospective reviews were performed by radiologists A and B, having 8 and 13 years of experience as radiologists (diagnosis 2 and 3), respectively. Positive diagnosis for the development of PN were assumed equivalent to positive predictions for the development of POF. We then calculated the area under the curve (AUC) of the receiver operating characteristic for POF predictions. RESULTS: Fourteen (17.9%) and 23 patients (29.5%) developed PN and POF, respectively. For diagnoses 1, 2, and 3, AUCs for POF predictions were 74, 68, and 73, respectively. CONCLUSIONS: Perfusion CT diagnoses pancreatic necrosis and on that basis predicts the development of POF; http://www.umin.ac.jp/ctr/index-j.htm,UMIN000001926 .

Original languageEnglish (US)
Pages (from-to)1130-1139
Number of pages10
JournalJournal of gastroenterology
Volume52
Issue number10
DOIs
StatePublished - Oct 1 2017

Keywords

  • Pancreatic necrosis
  • Perfusion CT
  • Persistent organ failure
  • Severe acute pancreatitis

ASJC Scopus subject areas

  • Gastroenterology

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    Tsuji, Y., Takahashi, N. M., Isoda, H., Koizumi, K., Koyasu, S., Sekimoto, M., Imanaka, Y., Yazumi, S., Asada, M., Nishikawa, Y., Yamamoto, H., Kikuchi, O., Yoshida, T., Inokuma, T., Katsushima, S., Esaka, N., Okano, A., Kawanami, C., Kakiuchi, N., ... Chiba, T. (2017). Early diagnosis of pancreatic necrosis based on perfusion CT to predict the severity of acute pancreatitis. Journal of gastroenterology, 52(10), 1130-1139. https://doi.org/10.1007/s00535-017-1330-5