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Ripolles T.,Hospital Dr Peset Universitario | Martinez M.J.,Hospital Dr Peset Universitario | Lopez E.,Hospital Dr Peset Universitario | Castello I.,Hospital Virgen de Los Lirios | Delgado F.,Hospital Dr Peset Universitario
European Radiology | Year: 2010

Objective: To determine the diagnostic value of contrast-enhanced ultrasound (CEUS) in the assessment of acute pancreatitis, with computed tomography (CT) as the reference standard. Methods: Fifty consecutive patients (mean age 58.4 years; range 23-86 years) with acute pancreatitis underwent prospectively both CT and ultrasonography, including CEUS, within a 24-h interval. Pancreatic vascularisation was evaluated with CEUS after injection of a second-generation US contrast-enhancing agent. Acute pancreatitis severity was graded according to the Balthazar index. The results were compared with CT severity index and clinical outcome by using Spearman's correlation coefficient. Results: A significant correlation between CT and CEUS was found for the CT severity index (r=0.926), extent of necrosis (r=0.893) and Balthazar grade (r=0.884). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detecting severe acute pancreatitis based on CT findings (severity index greater than 3 and/or presence of necrosis) were respectively 91%, 100%, 100% and 83%. A significant correlation between CEUS severity index and clinical variables was found: Ranson score (r=0.442), C-reactive protein (CRP) levels 48 h after admission (r=0.385) and length of hospital stay (r=0.362). Conclusion: CEUS is comparable to CT in detecting pancreatic necrosis as well as predicting its clinical course. Therefore, when CT is contraindicated CEUS may be a valid alternative. © 2010 European Society of Radiology.

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