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

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

Journal of Gastroenterology
pp 1–10, 03 April 2017

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

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.

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