Ultrasound predictors of severe acute pancreatitis
https://doi.org/10.24835/1607-0763-1380
Abstract
The objective of our study was to disclosed efficiency of ultrasound for the prediction of the severity of acute pancreatitis (AP).
Material and Methods. Our study included 322 hospitalized patients with AP. We studied and compare the efficacy of clinical scoring systems and radiologic data.
Results. Ultrasound findings showed sensitivity (Se) 72,9%, and specificity (Sp) 89,3% compared with the clinical scoring systems (Se from 27,1% to 48,6%, Sp from 80,3% to 100%, AUC from 0,538 to 0,645) and computed tomography (Se 85,4%, Sp 89,5%). Ultrasound showed a trend of a higher AUC in the prediction of severe AP (0.811) compared with the clinical scoring systems (0,538 до 0,645) and computed tomography (AUC 0,854).
Conclusions. Abdominal ultrasound examination is a useful method for early prediction of the severity of acute pancreatitis.
About the Authors
Valeria A. RudenkoRussian Federation
Valeria A. Rudenko – Ultrasound diagnostics doctor at the Department of Functional and Ultrasound Diagnostics, Clinical Emergency Hospital of Ufa;
Graduate Student of the department of radiation diagnostics and radiation therapy, nuclear medicine and radiotheraphy, Bashkir State Medical University, Ufa
Lucia N. Kakaulina
Russian Federation
Lucia N. Kakaulina – Cand. of Sci. (Med.), Head of the Department of Functional and Ultrasound Diagnostics, Clinical Emergency Hospital of Ufa;
Associate Professor of the department of radiation diagnostics and radiation therapy, nuclear medicine and radiotheraphy, Bashkir State Medical University, Ufa
Andrey G. Kakaulin
Russian Federation
Andrey G. Kakaulin – Cand. of Sci. (Med.), Associate Professor of the department of Anesthesiology and Intensive Care, Bashkir State Medical University, Ufa
Irina M. Karamova
Russian Federation
Irina M. Karamova – Doct. of Sci. (Med.), Professor, Chief Physician of Clinical Emergency Hospital of Ufa, Ufa
Aliia I. Faizova
Russian Federation
Aliia I. Faizova – Ultrasound diagnostics doctor at the Department of Functional and Ultrasound Diagnostics, Clinical Emergency Hospital of Ufa, Ufa
References
1. Revishvili A.Sh., Olovyannyi V.E., Sazhin V.P., Nechaev O.I. et al. Surgical care in the Russian Federation. M., 2019. 36 с.(In Russian)
2. Revishvili A.Sh., Olovyanniy V.E., Sazhin V.P., Anishchenko M.M. Surgical care in the Russian Federation during the pandemic — the main results of 2020. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2021; 12: 5–14. https://doi.org/10.17116/hirurgia20211215 (In Russian)
3. Singh V.K., Bollen T.L., Wu B.U. et al. An assessment of the severity of interstitial pancreatitis. Clin. Gastroenterol. Hepatol. 2011; 9 (12): 1098–1103. http://doi.org/10.1016/j.cgh.2011.08.026
4. van Santvoort H.C., Bakker O.J., Bollen T.L. et al.; Dutch Pancreatitis Study Group. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011; 141 (4): 1254–1263. http://doi.org/10.1053/j.gastro.2011.06.073
5. Chauhan S., Forsmark C.E. The difficulty in predicting outcome in acute pancreatitis. Am. J. Gastroenterol. 2010; 105 (2): 443–445. http://doi.org/10.1038/ajg.2009.623
6. Mounzer R., Langmead C.J., Wu B.U. et al. Comparison of existing clinical scoring systems to predict persistent organ failure in patients with acute pancreatitis. Gastroenterology. 2012; 142 (7): 1476–1482; quiz e15–6. http://doi.org/10.1053/j.gastro.2012.03.005
7. Wang X., Xu Y., Qiao Y. et al. An evidence-based proposal for predicting organ failure in severe acute pancreatitis. Pancreas. 2013; 42 (8): 1255–1261. http://doi.org/10.1097/MPA.0b013e3182a5d6a7
8. Yang C.J., Chen J., Phillips A.R. et al. Predictors of severe and critical acute pancreatitis: a systematic review. Dig. Liver Dis. 2014; 46 (5): 446–451. http://doi.org/10.1016/j.dld.2014.01.158
9. Kwong W.T., Ondrejková A., Vege S.S. Predictors and outcomes of moderately severe acute pancreatitis – Evidence to reclassify. Pancreatology. 2016; 16 (6): 940–945. http://doi.org/10.1016/j.pan.2016.08.001
10. Trufanov G.E., Rud' S.D., Bagnenko S.S. Radiation diagnosis of pancreatic diseases. 2nd ed. SPb.: Elbi, 2011: 119–136. ISBN: 978-5-93979-235-6 (In Russian)
11. Bollen T.L., Singh V.K., Maurer R. et al. A comparative evaluation of radiologic and clinical scoring systems in the early prediction of severity in acute pancreatitis. Am. J. Gastroenterol. 2012; 107 (4): 612–619. http://doi.org/10.1038/ajg.2011.438
12. Pezzilli R., Zerbi A., Di Carlo V. et al.; Working Group of the Italian Association for the Study of the Pancreas on Acute Pancreatitis. Practical guidelines for acute pancreatitis. Pancreatology. 2010; 10 (5): 523–535. http://doi.org/10.1159/000314602
13. Expert Panel on Gastrointestinal Imaging; Porter K.K., Zaheer A., Kamel I.R. et al. ACR Appropriateness Criteria® Acute Pancreatitis. J. Am. Coll. Radiol. 2019; 16 (11S): S316–S330. http://doi.org/10.1016/j.jacr.2019.05.017
14. Arvanitakis M., Delhaye M., De Maertelaere V. et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis. Gastroenterology. 2004; 126 (3): 715–723. http://doi.org/10.1053/j.gastro.2003.12.006
15. Arablinskii A.V., Titov M.Y. CT and MRI in the diagnosis of the phase course of necrotizing pancreatitis (literature review). Medical Visualization. 2022; 26 (2): 139–153. https://doi.org/10.24835/1607-0763-1110 (In Russian)
16. Nudnov N.V., Yadrentseva S.V. Multislice Computed Tomography in the Diagnosis, Assessment of Severity and Prognosis of Acute Pancreatitis and its Complications. Medical Visualization. 2014; 5: 45–52. (In Russ.)
17. Paklina O.V., Karmazanovsky G.G., Setdikova G.R. Pathomorphological and radiological diagnosis of surgical diseases of the pancreas. M.: Vidar-M, 2014. 188 p. ISBN: 978-5-88429-191-1 (In Russian)
18. Acute pancreatitis. Clinical recommendations. 2020 (20.04.2021) https://cr.minzdrav.gov.ru/schema/326_4 (In Russian)
19. D’Onofrio M. (Ed.) Ultrasonography of the Pancreas. Imaging and Pathologic Correlations. Springer-Verlag Italia, 2012: 83–86. ISBN-10: 8847023785. ISBN-13: 978-8847023789
20. Rickes S., Uhle C., Kahl S. et al. Echo enhanced ultrasound: a new valid initial imaging approach for severe acute pancreatitis. Gut. 2006; 55 (1): 74–78. https://doi.org/10.1136/gut.2005.070276
21. Popescu A., Sporea I., Bota S. et al. The Usefulness of Abdominal Ultrasound for the Evaluation of Patients With Acute Pancreatitis. Ultrasound Med. Biol. 2013; 39 (5): S2 https://doi.org/10.1016/j.ultrasmedbio.2013.02.024
22. Choi H.W., Park H.J., Choi S.Y. et al. Early Prediction of the Severity of Acute Pancreatitis Using Radiologic and Clinical Scoring Systems With Classification Tree Analysis. Am. J. Roentgenol. 2018; 211 (5): 1035–1043. https://doi.org/10.2214/AJR.18.19545
23. Balthazar E.J. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology. 2002; 223 (3): 603–613. https://doi.org/10.1148/radiol.2233010680
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Supplementary files
Review
For citations:
Rudenko V.A., Kakaulina L.N., Kakaulin A.G., Karamova I.M., Faizova A.I. Ultrasound predictors of severe acute pancreatitis. Medical Visualization. 2024;28(2):54-64. (In Russ.) https://doi.org/10.24835/1607-0763-1380