Aim: Comparison of two imaging modalities and their application in the evaluation of pancreatic/peripancreatic changes due to acute pancreatitis.
Materials and Methods: The present comparative study was performed on 100 patients suspected of acute pancreatitis confirmed by elevated serum amylase and serum lipase levels, between November 2015 to May 2017 in the Department of Radiodiagnosis in Victoria Hospital and Bowring and Lady Curzon Hospital attached to Bangalore Medical College and Research Institute, Bengaluru. All patients underwent a real-time ultrasound scan of the abdomen using a curvilinear transducer of 2 to 6 MHz of Philips IU22 and triple-phase contrast-enhanced computed tomography of the abdomen by Philips INGENUITY 128 slice CT in Victoria hospital or Siemens SOMATOM 6 slice CT present in Bowring hospital.
Results: Most patients with acute pancreatitis (~30%) belonged to the age group 41-50 years while 28% each belonged to the age group 31-41 and 41-50 years respectively. Amongst males (n=88), 72% (n=64) were cases of acute pancreatitis and 28% (n=24) were the cases of acute on pancreatitis. On the other hand, of 12 females, 58% (n=07) were the cases of acute pancreatitis and 42% (n=05) were the cases of acute on chronic pancreatitis. Both ultrasonography (US) and MDCT were able to delineate normal-sized pancreas, increased size of head and body of pancreas and atrophic pancreas. While the US was able to identify only 17 cases, CT was able to detect 55 with a sensitivity of ~31%, which was statistically significant (p<0.001). Both CT and US detected equal cases of necrosis involving the body of the pancreas, while US detected one less case of necrosis involving the head of the pancreas than CT.
Conclusion: It is seen that both US and CT have roles to play in the diagnosis of pancreatitis and both are complementary to each other. However, MDCT was proved to be the imaging modality of choice in imaging pancreatitis and allowing accurate diagnosis of associated complications.