Comparison of ultrasound and Contrast- enhanced computed tomography in clinically diagnosed cases of acute pancreatitis

Introduction: Acute pancreatitis (AP) is an acute, mainly diffuse, inflammatory process of the pancreas with dynamic imaging characteristics and a multitude of possible complications. Imaging plays an important role in the diagnosis of AP. As most of the AP cases are gallstone-related, ultrasound (USG) is the most common initial radiologic investigation of choice. Contrast-enhanced CT (CECT) is the standard technique for overall assessment of AP and its complications. This study aims to compare diagnostic accuracy of imaging findings of USG with CECT. Method: This was a retrospective review of imaging findings of USG and CECT in clinically diagnosed cases of AP who visited Radiology Department of Patan Hospital, Patan Academy of Health Sciences, Kathmandu, Nepal during 2015 to 2019 and had undergone USG and CECT. The diagnostic accuracy of USG and CECT imaging findings were compared. Study was approved ethically. Result: Among 210 clinically diagnosed cases of acute pancreatitis, USG accurately diagnosed 97(46.2%), CECT 180(85.7%). Both the modalities detected cholelithiasis in 17% of the cases. Out of 97 cases, 85 showed focal or diffuse enlargement of pancreas on USG. Conclusion: The CECT showed higher diagnostic accuracy for acute pancreatitis as compared to ultrasound, 85.7% vs. 46.2%. The overall visualization of the imaging features of AP and its complications was better by CECT than by USG.

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Combined Hepatocellular and Cholangiocarcinoma (Biphenotypic) Tumors: Imaging Features and Diagnostic Accuracy of Contrast-Enhanced CT and MRI

American Journal of Roentgenology ◽

10.2214/ajr.12.9488 ◽

2013 ◽

Vol 201 (2) ◽

pp. 332-339 ◽

Cited By ~ 114

Author(s):

Kathryn J. Fowler ◽

Arman Sheybani ◽

Rex A. Parker ◽

Sean Doherty ◽

Elizabeth M. Brunt ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Imaging Features ◽

Combined Hepatocellular And Cholangiocarcinoma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Ct And Mri

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Imaging Findings in Neonates With Congenital Pyriform Sinus Fistula: A Retrospective Study of 45 Cases

Frontiers in Pediatrics ◽

10.3389/fped.2021.721128 ◽

2021 ◽

Vol 9 ◽

Author(s):

Li Li ◽

Dong-Ji-Hui Zhao ◽

Tao-Yue Yao ◽

Yong-Hua Xiang ◽

Hong Liu ◽

...

Keyword(s):

Retrospective Study ◽

Pyriform Sinus ◽

Supplementary Information ◽

Retropharyngeal Space ◽

Imaging Features ◽

Imaging Findings ◽

Pyriform Sinus Fistula ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Background: Congenital pyriform sinus fistula (CPSF) is a rare branchial cleft deformity. The characteristics and management of CPSF in neonates are different from those in children or adults, and a comprehensive understanding of the imaging features of neonatal CPSF can facilitate its preoperative diagnosis. Thus, the aim of this study was to summarize the ultrasonography (US) and CT imaging findings of CPSF in neonates.Methods: Forty-five full-term neonates with CPSF, confirmed by pathology after surgical resection from January 2012 to October 2020, were included in this retrospective study. All patients underwent preoperative cervical US and contrast-enhanced CT examinations, and the imaging findings were analyzed.Results: Forty-six cervical cystic masses were found in 45 neonates, including one case with bilateral lesions, three cases with lesions on the right side, and 41 cases on the left side. Both US and CT detected neck abnormality among all cases, while the diagnostic accuracy of US (15/46, 32.6%) was lower than that of CT (42/46, 91.3%). Moreover, CT showed significantly higher detection rates of intralesional air bubbles, involvement of the ipsilateral thyroid, deviation of the airway, and expansion into the mediastinal and retropharyngeal space compared with the US. As the age increased, it was more likely to present some features including the absence of air-containing, thick cyst wall, and poorly defined border (ρ <0.05).Conclusion: CPSF in the neonates showed distinctive imaging findings on contrast-enhanced CT scan, which provides important supplementary information for the diagnosis of CPSF after the initial US examination.

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Acute pancreatitis, its diagnosis with special reference to contrast enhanced CT scan (CECT) and serum enzyme studies: a comparative study in tertiary referral hospital of Odisha, India

International Surgery Journal ◽

10.18203/2349-2902.isj20175403 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4022 ◽

Cited By ~ 1

Author(s):

Srikanta Panda ◽

Roshni Tirkey ◽

Basanta Manjari Swain ◽

Somanatha Jena ◽

Ashok Kumar Sarangi ◽

...

Keyword(s):

Acute Pancreatitis ◽

Diagnostic Accuracy ◽

Ct Scan ◽

Serum Amylase ◽

Serum Enzymes ◽

Serum Lipase ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Cect Scan

Background: Acute pancreatitis is sudden swelling and inflammation of the pancreas. It can be diagnosed on the basis of clinical and laboratory data. At times, it may be difficult to differentiate it from other acute abdominal conditions. In these patients, serum enzymes (amylase and lipase) study, imaging by ultrasonography (USG) and/or computed tomography (CT) is of immense value in arriving at a diagnosis. In this study, we have compared the role of serum enzymes (amylase and lipase) levels, with the imaging studies (US/CECT scan) in relation to early diagnosis of acute pancreatitis and to find out the most specific and sensitive diagnostic modality.Methods: 300 patients (220 males, 80 females) in age group of 21 to 62 years with a clinical diagnosis of acute pancreatitis, which were admitted to surgical ward of S.C.B. Medical College Hospital, Cuttack during a period from November 2013 to October 2015, were included in the study. All selected cases (clinically diagnosed as acute pancreatitis) were serially subjected to tests of serum amylase and lipase estimation, USG and CECT scan of abdomen.Results: In our study the most common cause found was gall stone disease followed by chronic alcoholism. Serum amylase test showed diagnostic accuracy of 46.66% whereas serum lipase it was 70 %. Further USG of abdomen diagnostic accuracy was 83.33%, finally CECT scan had a diagnostic accuracy of 93.33%.Conclusions: Comparing all the diagnostic modalities described above it was found that contrast enhanced CT scan has highest accuracy rate (i.e. about 93% in our study) in detecting acute pancreatitis. This study proved that CECT scan was very important in the following up of the patients in order to detecting regression of disease appearance and complication in relation to acute pancreatitis.

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CT diagnosis of ilioinguinal lymph node metastases in melanoma using radiological characteristics beyond size and asymmetry

BJS Open ◽

10.1093/bjsopen/zraa005 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

M J Wilkinson ◽

H Snow ◽

K Downey ◽

K Thomas ◽

A Riddell ◽

...

Keyword(s):

Lymph Node ◽

Diagnostic Accuracy ◽

Multivariable Analysis ◽

Ct Scans ◽

Non Invasive ◽

Poor Predictor ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Node Metastases

Abstract Background Diagnosis of lymph node (LN) metastasis in melanoma with non-invasive methods is challenging. The aim of this study was to evaluate the diagnostic accuracy of six LN characteristics on CT in detecting melanoma-positive ilioinguinal LN metastases, and to determine whether inguinal LN characteristics can predict pelvic LN involvement. Methods This was a single-centre retrospective study of patients with melanoma LN metastases at a tertiary cancer centre between 2008 and 2016. Patients who had preoperative contrast-enhanced CT assessment and ilioinguinal LN dissection were included. CT scans containing significant artefacts obscuring the pelvis were excluded. CT scans were reanalysed for six LN characteristics (extracapsular spread (ECS), minimum axis (MA), absence of fatty hilum (FH), asymmetrical cortical nodule (CAN), abnormal contrast enhancement (ACE) and rounded morphology (RM)) and compared with postoperative histopathological findings. Results A total of 90 patients were included. Median age was 58 (range 23–85) years. Eighty-eight patients (98 per cent) had pathology-positive inguinal disease and, of these, 45 (51 per cent) had concurrent pelvic disease. The most common CT characteristics found in pathology-positive inguinal LNs were MA greater than 10 mm (97 per cent), ACE (80 per cent), ECS (38 per cent) and absence of RM (38 per cent). In multivariable analysis, inguinal LN characteristics on CT indicative of pelvic disease were RM (odds ratio (OR) 3.3, 95 per cent c.i. 1.2 to 8.7) and ECS (OR 4.2, 1.6 to 11.3). Cloquet’s node is known to be a poor predictor of pelvic spread. Pelvic LN disease was present in 50 per cent patients, but only 7 per cent had a pathology-positive Cloquet’s node. Conclusion Additional CT radiological characteristics, especially ECS and RM, may improve diagnostic accuracy and aid clinical decisions regarding the need for inguinal or ilioinguinal dissection.

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The role of contrast enhanced CT in acute pancreatitis

Clinical Radiology ◽

10.1016/s0009-9260(89)80406-4 ◽

1989 ◽

Vol 40 (6) ◽

pp. 649

Keyword(s):

Acute Pancreatitis ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

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MRCP Combined With CT Promotes the Differentiation of Benign and Malignant Distal Bile Duct Strictures

Frontiers in Oncology ◽

10.3389/fonc.2021.683869 ◽

2021 ◽

Vol 11 ◽

Author(s):

Guang-xian Wang ◽

Xiao-dong Ge ◽

Dong Zhang ◽

Hai-ling Chen ◽

Qi-chuan Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Diagnostic Accuracy ◽

Multiple Logistic Regression Analysis ◽

Magnetic Resonance Cholangiopancreatography ◽

Threshold Value ◽

Arterial Phase ◽

Multiple Logistic Regression ◽

Scoring Model ◽

Contrast Enhanced Ct ◽

Contrast Enhanced

ObjectiveTo determine whether contrast-enhanced computed tomography (CT) can promote the identification of malignant and benign distal biliary strictures (DBSs) compared to the use of magnetic resonance cholangiopancreatography (MRCP) alone and to identify imaging findings of malignant DBSs.Materials and MethodsA total of 168 consecutive patients with confirmed DBSs were reviewed. MRCP alone and MRCP combined with CT images were blindly analyzed by two radiologists (e.g., stricture pattern, margins), and malignant or benign DBSs were identified based on surgical findings, endoscopy findings, or follow-up. The diagnostic accuracy of the two reviewers using MRCP alone and MRCP combined with CT were evaluated. MRCP and CT features of malignant and benign DBSs were compared using multiple logistic regression analysis to identify independent malignant risk factors.ResultsMRCP combined with CT examination could improve the diagnostic accuracy, which increased from 70.2% to 81.5% in Doctor A and from 85.1% to 89.3% in Doctor B. The multiple logistic regression model revealed that stricture length [odds ratio (OR) 1.070, P=0.016], angle of the DBS (OR 1.061, P<0.001), double duct sign (OR 4.312, P=0.003) and low density in the arterial phase (OR 0.319, P=0.018) were associated with malignant DBS. A scoring model incorporating these four factors was established; at a threshold value of 1.75, and the sensitivity and specificity for the detection of malignant DBSs were 73.5 and 85.9%, respectively.ConclusionsCompared to the use of MRCP alone, MRCP combined with contrast-enhanced CT can improve the accuracy of DBS diagnosis. The scoring model accurately predicts malignant DBSs and helps make treatment decisions.

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Ultrasound and CT imaging features in a patient with salivary duct carcinoma of the parotid gland: a case report with literature review.

Medical Ultrasonography ◽

10.11152/mu.2013.2066.171.dif ◽

2015 ◽

Vol 17 (1) ◽

pp. 119

Author(s):

Diana Ioana Fenesan ◽

Manuela Lenghel ◽

Grigore Baciut ◽

Sergiu Vacaras ◽

Carolina Botar-Jid ◽

...

Keyword(s):

Parotid Gland ◽

Lymph Nodes ◽

Ct Imaging ◽

Salivary Duct Carcinoma ◽

Imaging Features ◽

Salivary Duct ◽

Duct Carcinoma ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Mass Expansion

The aim of this paper was to present the ultrasound (US) and computed tomography (CT) appearance of a patient with salivary duct carcinoma of the parotid gland. US showed a voluminous mass of the parotid gland, with multiple calcifications. Furthermore, it revealed regional multiple lymph nodes with malignant characters. Sonoelastography of the lesion and lymph nodes detected increased rigidity. Contrast enhanced CT scan of the neck completed the data description regarding the mass expansion and invasion of surrounding tissues. US and CT imaging features played a key role in establishing the malignant character of the mass and lymph nodes.

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