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Forest plot of MRI and CT in the diagnosis of acute pancreatitis. AP, acute pancreatitis; TP, true positive; FP, false positive; FN, false negative; TN, true negative; CI, confidence interval; MRI, magnetic resonance imaging; CT, computed tomography.
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Background:
Acute pancreatitis (AP) is characterized by acute onset, rapid development, and poor prognosis. Timely diagnosis and identification of the cause are the key to formulating the clinical program and improving the prognosis. There were several studies on this topic but the results varied. This study systematically evaluated and analyzed r...
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Citations
... Düşük enzim düzeylerinde (düzeyleriyle), hastalığın şiddeti arasında bir korelasyon yoktur [13]. AP şüphesi bulunması halinde batın tomografisi ve manyetik rezonans görüntüleme yöntemleri pankreatite ait değişiklikleri sırasıyla %73'e karşın %92 duyarlılık ve %64'e karşın %74 özgüllükle gösterebilmektedir [14]. Ca 9,1 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 9,1 (5,(7)(8)(9)(10)(11)(12)9) 8,7 (6,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 0,000 9,23 (7,31-10,38) 9,1 (5,(9)(10)(11)(12)9) 8,9 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) [7] yaptığı çalışmada hastaların %67,5'i kadın, %32,5'i erkek olup yaş ortalaması 55,2'dir. ...
... AP şüphesi bulunması halinde batın tomografisi ve manyetik rezonans görüntüleme yöntemleri pankreatite ait değişiklikleri sırasıyla %73'e karşın %92 duyarlılık ve %64'e karşın %74 özgüllükle gösterebilmektedir [14]. Ca 9,1 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 9,1 (5,(7)(8)(9)(10)(11)(12)9) 8,7 (6,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 0,000 9,23 (7,31-10,38) 9,1 (5,(9)(10)(11)(12)9) 8,9 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) [7] yaptığı çalışmada hastaların %67,5'i kadın, %32,5'i erkek olup yaş ortalaması 55,2'dir. Yaş ortalaması bizim hasta grubumuzdakine benzer olan bu çalışmaların hepsinde kadın cinsiyetinin daha fazla görülmesi bunları bizim çalışmamızdan farklı kılmıştır. ...
... AP şüphesi bulunması halinde batın tomografisi ve manyetik rezonans görüntüleme yöntemleri pankreatite ait değişiklikleri sırasıyla %73'e karşın %92 duyarlılık ve %64'e karşın %74 özgüllükle gösterebilmektedir [14]. Ca 9,1 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 9,1 (5,(7)(8)(9)(10)(11)(12)9) 8,7 (6,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) 0,000 9,23 (7,31-10,38) 9,1 (5,(9)(10)(11)(12)9) 8,9 (5,(7)(8)(9)(10)(11)(12)(13)(14)(15)9) [7] yaptığı çalışmada hastaların %67,5'i kadın, %32,5'i erkek olup yaş ortalaması 55,2'dir. Yaş ortalaması bizim hasta grubumuzdakine benzer olan bu çalışmaların hepsinde kadın cinsiyetinin daha fazla görülmesi bunları bizim çalışmamızdan farklı kılmıştır. ...
Purpose: The aim of this study is to investigate the demographic data of the patients diagnosed with acute pancreatitis (AP), find out etiological factors and relation of labortaory data with the outcome in the emergency department. Materials and methods: The data of patients diagnosed with AP in the Emergency Department of Suleyman Demirel University, between 2013 and 2017 were analyzed retrospectively. The patients' demographic, laboratory and imaging findings were noted. Patients’ outcomes were evaluated in terms of hospitalization and in-hospital mortality.Results: Of the 603 patients in the study, 290 (48.1%) were female and 313 (51.9%) were male. The mean age of the patients was 59.49±18.73 years. The most applications were in the winter (n=161 [26.7%]) and the least in the spring (n=143 [23.7%]). The neutrophil counts of the discharged patients were lower than the patients hospitalized in the ward and intensive care unit. Primary etiology of the pancreatitis was biliary. The neutrophil/lymphocyte ratio (NLR) was significantly higher in the patients hospitalized or died in the intensive care unit, and the glucose and lactate dehydrogenase values are higher in the patients hospitalized in the intensive care unit. In-hospital mortality was 6.5%.Conclusion: Biliary pancreatitis is the main cause of pancreatitis. Mortality in AP is 6.5%. The admission NLR value is increased significantly in patients who need intensive care and in cases with in-hospital mortality.
... Our previous research has also confirmed this point demonstrating the EPIM score to be more helpful in evaluating the severity of AP than either the MRSI and MMRSI in the early stage of AP (7,20). Another possible reason may be that MRI is more sensitive than CT in detecting slight changes of mild inflammation and effusion (28,29). ...
Background:
The aim of this study was to develop a new model constructed by logistic regression for the early prediction of the severity of acute pancreatitis (AP) using magnetic resonance imaging (MRI) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring system.
Methods:
This retrospective study included 363 patients with AP. The severity of AP was evaluated by MRI and the APACHE II scoring system, and some subgroups of AP severity were constructed based on a combination of these two scoring systems. The length of stay and occurrence of organ dysfunction were used as clinical outcome indicators and were compared across the different subgroups. We combined the MRI and APACHE II scoring system to construct the regression equations and evaluated the diagnostic efficacy of these models.
Results:
In the 363 patients, 144 (39.67%) had systemic inflammatory response syndrome (SIRS), 58 (15.98%) had organ failure, and 17 (4.68%) had severe AP. The AP subgroup with a high MRI score and a simultaneously high APACHE II score was more likely to develop SIRS and had a longer hospitalization. The model, which predicted the severity AP by combining extrapancreatic inflammation on magnetic resonance (EPIM) and APACHE II, was successful, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.912, which was higher than that of any single parameter. Other models that predicted SIRS complications by combining MRI parameters and APACHE II scores were also successful (all P<0.05), and these models based on EPIM and APACHE II scores were superior to other models in predicting outcome.
Conclusions:
The combination of MRI and clinical scoring systems to assess the severity of AP is feasible, and these models may help to develop personalized treatment and management.
This is a current update on radiologic imaging and intervention of acute pancreatitis and its complications. In this review, we define the various complications of acute pancreatitis, discuss the imaging findings, as well as the timing of when these complications occur. The various classification and scoring systems of acute pancreatitis are summarized. Advantages and disadvantages of the 3 primary radiologic imaging modalities are compared. We then discuss radiologic interventions for acute pancreatitis. These include diagnostic aspiration as well as percutaneous catheter drainage of fluid collections, abscesses, pseudocysts, and necrosis. Recommendations for when these interventions should be considered, as well as situations in which they are contraindicated are discussed. Fortunately, acute pancreatitis usually is mild; however, serious complications occur in 20%, and admission of patients to the intensive care unit (ICU) occurs in over 10%. In this paper, we will focus on the imaging and interventional radiologic aspects for the serious complications and patients admitted to the ICU.
Acute pancreatitis (AP) is a potentially life-threatening inflammatory disease of the pancreas, with clinical management determined by the severity of the disease. Diagnosis, severity prediction, and prognosis assessment of AP typically involve the use of imaging technologies, such as computed tomography, magnetic resonance imaging, and ultrasound, and scoring systems, including Ranson, Acute Physiology and Chronic Health Evaluation II, and Bedside Index for Severity in AP scores. Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity, while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications. Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild, moderate, or severe categories, guiding treatment decisions, such as intensive care unit admission, early enteral feeding, and antibiotic use. Despite the central role of imaging technologies and scoring systems in AP management, these methods have limitations in terms of accuracy, reproducibility, practicality and economics. Recent advancements of artificial intelligence (AI) provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data. AI algorithms can analyze large amounts of clinical and imaging data, identify scoring system patterns, and predict the clinical course of disease. AI-based models have shown promising results in predicting the severity and mortality of AP, but further validation and standardization are required before widespread clinical application. In addition, understanding the correlation between these three technologies will aid in developing new methods that can accurately, sensitively, and specifically be used in the diagnosis, severity prediction, and prognosis assessment of AP through complementary advantages.
Background: The mortality and morbidity associated with acute pancreatitis (AP) demands timely management and prediction of disease progression and clinical outcome. Multifactorial scoring systems shall facilitate risk stratification and prognostic assessment in AP. Aims and Objectives: The aim of the study was (i) to assess C-reactive protein (CRP) levels and modified computed tomography severity index (mCTSI) in AP patients and their association with the clinical outcome and (ii) to determine the correlation between CRP levels and mCTSI scores in AP. Materials and Methods: This cross-sectional, hospital-based study comprised 90 patients diagnosed with AP. Data collection included sociodemographic information, clinical presentation, and CRP estimation. The mCTSI score was estimated by axial slices contrast-enhanced computed tomography of abdomen and was used to assess the severity of AP. Categorical data were analyzed by Chi-square test and Pearson’s coefficient was estimated to determine the correlation between CRP levels and mCTSI score. P<0.05 was adopted as level of significance. Results: The study comprised 81 males (90%) and 9 females (10%). The mean age of the patients was 36.94±9.19 years, with majority in age group of 31–40 years (40%). Alcohol consumption (>50 g/day) was the commonest risk factor in 82.22% (n=74) patients, followed by hypertriglyceridemia in 13.33% (n=12) patients. Pain in abdomen was the most common presentation in 96.67% (n=87) patients, followed by vomiting 57.78% (n=52) patients. Majority of patients [82.22% (n=74)] had CRP levels of 10–21 mg/dL. Mild, moderate, and severe mCTSI scores were obtained in 17.78%, 66.67%, and 15.55% patients, respectively. There is a significant positive correlation between CRP values and mCTSI scores with r=0.3008 (P=0.003). Conclusion: CRP level had significant positive correlation with mCTSI scores in AP. Higher values of CRP and severe mCTSI scores had worse clinical outcome in AP.
