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Perfusion CT Detects Early Signs of Pancreatic Necrosis

It can detect the ischemic changes that lead to the severest form of pancreatitis

THURSDAY, Dec. 6 (HealthDay News) -- In patients with severe acute pancreatitis, pancreatic necrosis is preceded by ischemic changes that can be detected by perfusion computerized tomography (CT), according to a study published in the December issue of Clinical Gastroenterology and Hepatology.

Yoshihisa Tsuji, M.D., of Kyoto University Graduate School of Medicine in Japan, and colleagues conducted a study of 30 patients with severe acute pancreatitis who were admitted to hospital within three days of onset of symptoms. All the patients underwent perfusion CT and three weeks later underwent conventional contrast-enhanced CT to assess disease progression.

Of the 10 patients that were diagnosed with pancreatic ischemia by perfusion CT, nine went on to develop pancreatic necrosis, while the remaining 20 patients did not. Perfusion CT had 100 percent sensitivity and 95.3 percent specificity for prediction of pancreatic necrosis.

"We believe that the routine use of perfusion CT will permit more accurate prediction of acute necrotizing pancreatitis and may help improve the prognosis of patients with severe acute pancreatitis," the authors write. "However, because a considerable number of severe acute pancreatitis patients without pancreatic necrosis also die at an early stage as a result of multiorgan failure, further study is required to find better prognostic markers."

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