DIAGNOSIS OF ACUTE NECROTIZING PANCREATITIS BY PERFUSION CT IN THE ERALY PHASE OF ACUTE PANCREATITIS

Abstract

Perfusion imaging by MDCT (perfusion CT) is a new modality to measure tissue perfusion of the pancreas in acute pancreatitis.1 We examined whether perfusion CT in the early phase of acute pancreatitis can detect ischemic area in the pancreas leading to pancreatic necrosis. We investigated pancreatic perfusion measurement using MDCT in 12 patients with acute pancreatitis within the first 72 hr after the onset and two weeks after the admission. Perfusion, peak enhancement intensity and blood volume was significantly lower in poorly perfused area of the pancreas in acute necrotizing pancreatitis (ANP) than those in acute edematous pancreatitis (AEP) and those in perfused area of the pancreas in ANP on admission (Table 1). Two weeks later, perfusion in AEP and perfused area of ANP was recovered to almost normal range, whereas perfusion in poorly perfused area (ischemic area) of the pancreas in ANP was decreased (Fig. 1). Pancreatic necrosis was confirmed by operation or follow-up CT examination in accordance with the ischemic region of the pancreas detected by perfusion CT. Perfusion CT in the early phase of acute pancreatitis is useful for detection of ischemic change in the pancreas leading to pancreatic necrosis.TABLE 1: Parameters of Perfusion CT in Cases with Acute PancreatitisFIGURE 1: Changes in perfusion parameters of the pancreas: A, perfusion; B, blood volume. AEP: acute edematous pancreatitis ANP: acute necrotizing pancreatitis.