The Role of Volume Perfusion CT in the Diagnosis of Pathologies of the Pancreas

Grözinger, Gerd; Grözinger, A.; Horger, Marius

doi:10.1055/s-0034-1384876

Cited by 24 publications

(15 citation statements)

References 35 publications

(52 reference statements)

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“…All authors agree that both in acute and chronic pancreatitis BF and BV measurements are significantly lower than in normal pancreatic gland, in which mean BF is 70–90 mL/min/100g according to Patlak analysis, 80–130 mL/min/100g using maximum slope method, and 120-140ml/min/100g using deconvolution technique [ 30 , 34 – 36 , 40 , 47 – 49 ].…”

Section: Discussionmentioning

confidence: 89%

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Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

et al. 2016

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PurposeSevere 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 Methods79 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.ResultsStatistical 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.ConclusionsCT 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.

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Section: Discussionmentioning

confidence: 89%

“…Decrease in BF and BV may be explained by cellular edema, thrombosis of the pancreatic microcirculation with resultant diminished microcirculatory function, and by vasospasm [ 13 , 30 , 37 , 38 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

et al. 2016

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“…20 P-CT was reported to be useful not only for AP but also for diagnosis of pancreas cancer, autoimmune pancreatitis, and more. 21 Differentiation of these diseases is important for treatment. 22,23 .…”

Section: T a B L Ementioning

confidence: 99%

Prediction of the progression of walled‐off necrosis in patients with acute pancreatitis on whole pancreatic perfusion CT

Yamamiya

Kitamura

Yoshida

et al. 2020

J Hepato Biliary Pancreat

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In recent years, the annual incidence of acute pancreatitis (AP) has ranged from 5 to 80 cases per 100 000 population, with mortality of 2%-10%. 1 Pancreatic/peripancreatic necrosis is involved in the aggravation of AP. The current gold standard for the diagnosis of pancreatic necrosis is contrast-enhanced computed tomography (CE-CT). 2 However, the CT value is qualitative. It has been reported that pancreatic perfusion CT (P-CT) can detect pancreatic ischemia. P-CT is used for early detection of brain ischemia, so it is one of the functional imaging modalities and can evaluate local site perfusion of the tissue. From the various data obtained by P-CT, a time-density curve (TDC) is drawn by rapid injection of the iodocontrast media transvenously, performing the same sectional consecutive scans over time; moreover, we

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“…On the other hand, detection of hypervascularized neuroendocrine pancreatic tumors may significantly be facilitated using VPCT [99]. Finally, the potential role of VPCT in the diagnosis of cystic pancreatic tumors seems to be marginal and is still under research.…”

Section: Pancreasmentioning

confidence: 99%

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

Thaiss

Sauter

Bongers

et al. 2015

European Journal of Radiology

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The Role of Volume Perfusion CT in the Diagnosis of Pathologies of the Pancreas

Cited by 24 publications

References 35 publications

Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

Prediction of the progression of walled‐off necrosis in patients with acute pancreatitis on whole pancreatic perfusion CT

Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology

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