scholarly journals Analysis of the Power of Common Diagnostic Tools in the Management of Acute Pancreatitis

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Markus Nistal ◽  
Malai Zoltani ◽  
Ansgar W. Lohse ◽  
Nicola Di Daniele ◽  
Manfredi Tesauro ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Predictive Value ◽  
Medical Condition ◽  
Diagnostic Tools ◽  
Surgical Interventions ◽  
Therapeutic Consequences ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Upper Abdominal ◽  
Enhanced Computed Tomography

Acute pancreatitis (AP) is a serious medical condition usually associated with severe upper abdominal pain. The purpose of our study is to assess the therapeutic consequences of contrast-enhanced computed tomography (CE-CT) and the predictive value of CRP for severe pancreatitis. We included patients with a threefold increase of plasma lipase who had received a CE-CT or had a CRP of =150 mg/dl. A total of 74 out of 283 patients got a contrast-enhanced CT scan; in 11 cases the CT was followed by endoscopic or surgical interventions as therapeutic consequences compared with 19 out of 50 control cases. 69 out of 283 patients (24,3%) had CRP >150 mg/dl within 48 hours after admission. 32 of them had SAP. The CRP cutoff of 150 mg/L had a sensitivity of 80% and a specificity of 65%. The positive predictive value for SAP in patients beyond the cutoff is 46.4%. The negative predictive value for SAP in patients below the cutoff was 89.5%. Our results support the opinion that an early CE-CT is usually not indicated. CRP helps to assess the course of AP; levels below 150 mg/dl between the first 48 h indicate a mild course in most of the cases.

scholarly journals Predictive value of neck imaging reporting and data system (NIRADS) in CECT/CEMRI of laryngeal and oral cavity squamous cell carcinoma

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Ahmed S. Abdelrahman ◽  
Manar Maamoun Mohamed Ashour ◽  
Tougan Taha Abdelaziz
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
Tumor Recurrence ◽  
Data System ◽  
Contrast Enhanced ◽  
Management Recommendations ◽  
Enhanced Computed Tomography

Abstract Background The neck imaging reporting and data system (NI-RADS) is a structured reporting algorithm linked with further patient management recommendations. This study was conducted to assess the overall and time point predictive value of the NI-RADS in laryngeal and oral cavity squamous cell carcinoma (SCC) using contrast-enhanced magnetic resonance imaging (CEMRI) and contrast-enhanced computed tomography (CECT). Results The rate of tumor recurrence was statistically different among the NI-RADS 1-3 categories with recurrence trend for higher NI-RADS scores. The overall negative predictive value (NPV) of the NI-RADS 1 and 2 were 94.3%, 74.3% respectively, and the positive predictive value (PPV) of the NI-RADS 3 was 80.8%. The overall recurrence rate of NI-RADS 3 was higher in oral cavity SCC (87.5%) compared to the laryngeal SCC (70%). The PPV of overall NI-RADS 3 in the follow-up scans (77.8%) was higher than in the first scan (70.6%). The odd ratio of tumor recurrence in NI-RADS 3 primary lesion was 19.6. Conclusion The predictive value of NI-RADS was significantly different among its categories. Increasing NI-RADS score is associated with increased recurrence among the treated laryngeal and oral cavity SCC. The morphological and enhancement lexicon features equally assign the NI-RADS 3 score.

scholarly journals Acute Pancreatitis and Diabetic Ketoacidosis following L-Asparaginase/Prednisone Therapy in Acute Lymphoblastic Leukemia

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Dania Lizet Quintanilla-Flores ◽  
Miguel Ángel Flores-Caballero ◽  
René Rodríguez-Gutiérrez ◽  
Héctor Eloy Tamez-Pérez ◽  
José Gerardo González-González
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Acute Lymphoblastic Leukemia ◽  
Diabetic Ketoacidosis ◽  
Lymphoblastic Leukemia ◽  
Remission Induction ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Hispanic Male ◽  
Contrast Enhanced Computed Tomography

Acute pancreatitis and diabetic ketoacidosis are unusual adverse events following chemotherapy based on L-asparaginase and prednisone as support treatment for acute lymphoblastic leukemia. We present the case of a 16-year-old Hispanic male patient, in remission induction therapy for acute lymphoblastic leukemia on treatment with mitoxantrone, vincristine, prednisone, and L-asparaginase. He was hospitalized complaining of abdominal pain, nausea, and vomiting. Hyperglycemia, acidosis, ketonuria, low bicarbonate levels, hyperamylasemia, and hyperlipasemia were documented, and the diagnosis of diabetic ketoacidosis was made. Because of uncertainty of the additional diagnosis of acute pancreatitis as the cause of abdominal pain, a contrast-enhanced computed tomography was performed resulting in a Balthazar C pancreatitis classification.

scholarly journals Computed Tomography Evaluation of Acute Pancreatitis and Its Complications – A Prospective Study at a Tertiary Referral Center

2021 ◽  
Vol 8 (11) ◽  
pp. 643-647
Author(s):  
Rama Krishna Narra ◽  
Manjeera Boddepalli ◽  
Narasimhachary Munjuwanpalli ◽  
Bhimeswarao Pasupaleti
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Prospective Study ◽  
Pancreatic Necrosis ◽  
Contrast Enhanced ◽  
Necrotising Pancreatitis ◽  
Enhanced Computed Tomography ◽  
A Prospective Study ◽  
Contrast Enhanced Computed Tomography ◽  
Score Index

BACKGROUND Acute pancreatitis (AP) is described as acute inflammation of the pancreas with or without peripancreatic abnormalities. The present study describes the role of computed tomography in the evaluation and grading of acute pancreatitis. Acute pancreatitis is a dynamic disease having biphasic mortality peaks due to two overlapping phases, which include early and late due to increased obesity, ageing of population, alcohol abuse, increased gall stone incidence, the worldwide AP incidence is increasing. Most important causes of AP in developing countries such as India include increased alcohol consumption. Contrast enhanced computed tomography plays an important role in diagnosis of the disease and helps in determining the prognosis of the disease. Modified CT severity index scoring system is the most commonly used scoring system for assessment of the severity of the disease. METHODS The present study is a prospective study of patients presenting with signs and symptoms of acute pancreatitis referred to the Department of Radio Diagnosis at Katuri medical college. This study comprised of 50 patients with clinical suspicion / diagnosis of acute pancreatitis, raised pancreatic biochemical parameters like serum amylase and serum lipase. Contrast enhanced computed tomography was performed in these patients, findings reported, and the disease was classified using modified CT scoring index system (MCTSI). RESULTS The mean age of the patients in the present study was 42.3 ± 12.28 years. Most of the patients presented with abdominal epigastric pain, abdominal distension. Acute pancreatitis was divided into acute oedematous pancreatitis and necrotising pancreatitis, the former being common. Complications included, ascites, pleural effusions, splenic vein thrombosis, portal venous thrombosis, and haemorrhages. CONCLUSIONS Contrast enhanced CT is useful to differentiate between oedematous and necrotising types of pancreatitis. The MCTSI helps in better evaluation of pancreatic necrosis grading. The modified computed tomography score index correlation with the development of local and systemic complications in acute pancreatitis is well established. Ideally, conducting contrast enhanced computed tomography (CECT) after 48 - 72 hours of acute attack, increases the probability of identifying necrotising pancreatitis. CT in particular has an overall accuracy of about 87 % and sensitivity and specificity of 100 % in the recognition of pancreatic necrosis. KEYWORDS Computed Tomography, Acute Pancreatitis, Pseudocyst, Modified CT Score Index

scholarly journals Morphometric analysis of the splenic artery using contrast-enhanced computed tomography (CT)

2020 ◽  
Author(s):  
David J. Brinkman ◽  
Stephanie Troquay ◽  
Wouter J. de Jonge ◽  
Eric D. Irwin ◽  
Margriet J. Vervoordeldonk ◽  
...  
Keyword(s):  
Immune Modulation ◽  
Splenic Artery ◽  
Experimental Studies ◽  
Pancreatic Tissue ◽  
Branching Pattern ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
And Gender ◽  
Enhanced Computed Tomography

Abstract Purpose To evaluate the morphology and course of the splenic artery, which might impact the surgical implantation of systems that stimulate the nerves surrounding the splenic artery. Experimental studies indicate that these nerves play an important part in immune modulation, and might be a potential target in the treatment of autoimmune diseases. Methods This retrospective cohort study made use of contrast-enhanced CT images from 40 male and 40 female patients (age 30–69) that underwent a CT examination of the aorta, kidneys or pancreas. Anatomic features were described including total splenic artery length, calibers, tortuosity, the presence of arterial loops and the branching pattern of the splenic artery. Results No age-gender-related differences could be found related to tortuosity or branching pattern. The length of splenic artery in contact with pancreatic tissue decreased with increasing age, but was not different between genders. Artery diameters were wider in male compared to female subjects. Loops of variable directions, that represent a part of the artery that curls out of the pancreatic tissue, were identified in each age-gender category and were present in nearly all subjects (86%). Conclusion This study suggests that although some anatomic features of the splenic artery are subject to factors as age and gender, the tortuosity of the splenic artery is not age dependent. Most subjects had one or multiple loops, which can serve as a target for neuromodulatory devices. Future studies should investigate whether splenic nerve stimulation is safe and feasible.

Imaging of a Rare Case of Diaphragmatic Tumor

2017 ◽  
Vol 3 (1) ◽  
pp. 25-27
Author(s):  
Ajit Reddy ◽  
Anil K Shukla ◽  
Sowmya Anand ◽  
Nitish Suresh
Keyword(s):  
Rare Case ◽  
Surgical Excision ◽  
Malignant Neoplasms ◽  
Primary Tumors ◽  
Contrast Enhanced ◽  
History Of ◽  
Upper Abdominal ◽  
Diaphragmatic Tumor ◽  
Enhanced Computed Tomography ◽  
Upper Abdomen

ABSTRACT Primary tumors of the diaphragm are quite rare. About 150 cases have been reported in the literature. Fibrosarcomas are the most common malignant neoplasms of the diaphragm; however, only a few (less than 20) cases have been reported to date. We present a case of an extremely rare tumor of the diaphragm. A 65-year-old woman presented with history of vague upper abdominal pain since 2 months and distension for 2 weeks. Ultrasonography features were in favor of a mass arising from left dome of diaphragm with evidence of vascularity on Doppler; lesion was displacing spleen inferiorly. Contrast-enhanced computed tomography scan of the abdomen revealed a mass located in the region of the left dome of diaphragm and deriving blood supply from the branches of abdominal aorta. Surgical excision was planned, keeping in mind the diagnosis of a left diaphragmatic tumor. Laparotomy revealed a left diaphragmatic tumor growing caudally into the upper abdomen. How to cite this article Anand S, Suresh N, Reddy AK, Shukla AK. Imaging of a Rare Case of Diaphragmatic Tumor. J Med Sci 2017;3(1):25-27.

scholarly journals Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Melisa Lim Seer Yee ◽  
Noraini Abdul Rahim ◽  
Ning Ajleaa Ngah ◽  
Yang Faridah Abdul Aziz ◽  
Sethu Subha
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Imaging Modality ◽  
Local Population ◽  
High Sensitivity ◽  
Neck Abscess ◽  
Contrast Enhanced ◽  
Study Population ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were recorded. 75 patients were diagnosed as having neck abscess on CECT; out of those 71 patients were found to have pus. Overall CECT findings were found to have a high sensitivity (98.6%) and positive predictive value (PPV) (94.7%) but lower specificity (67.2%) in diagnosing neck abscess. The CECT diagnostic criterion with the highest PPV is the presence of rim irregularity (96%). The most common deep neck space involved is the submandibular compartment, which correlates with the finding that odontogenic cause was the most common identifiable cause of abscess in the study population. Thus, in a patient clinically suspected of having neck abscess, CECT findings of a hypodense mass with rim irregularity are helpful in confirming the diagnosis and guiding clinical management.

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