Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Acute pancreatitis spans mild edema to necrosis with organ failure. We compared routine transabdominal ultrasound (US) with contrast-enhanced CT (CECT) for key findings and severity grading using MCTSI and Revised Atlanta categories. Prospective single-center study, n=75. All patients had baseline US and CECT at 48-72 h. Two blinded radiologists assessed enlargement, inflammatory changes, peripancreatic collections, ascites, biliary pathology, and vascular involvement; severity graded by MCTSI. Statistics: proportions, sensitivity/specificity/PPV/NPV (US vs CT), Cohen’s κ (including weighted κ for severity), and χ² for association of clinical (Atlanta) vs imaging severity. Detection (US vs CT): enlargement 77.3% vs 82.7%; inflammatory changes 80.0% vs 86.7%; collections 53.3% vs 50.7%; ascites 29.3% vs 26.7%; biliary pathology 37.3% vs 40.0%; vascular 8.0% vs 9.3%. US performance: collections 84.2%/90.0%, ascites 88.9%/96.4%, biliary 93.3%/91.0%, vascular 71.4%/97.0% (sensitivity/specificity). Agreement (κ): enlargement 0.72, inflammation 0.69, collections 0.76, ascites 0.80, biliary 0.78, vascular 0.55. MCTSI: mild 37.3%, moderate 40.0%, severe 22.7%. US severity showed moderate–good concordance with CT (weighted κ≈0.64–0.71). Clinical severity correlated with CT severity (χ²=26.87, df=4, p<0.001). US reliably identifies biliary pathology, ascites, and larger collections with good concordance to CT, but CT remains essential for definitive severity grading and detecting necrosis/vascular complications. Pragmatic pathway: early US for triage and etiology, followed by timed CT for comprehensive severity assessment.
How to cite this article:
K. Usharani and T. Srinivas. Comparative Evaluation of Ultrasound and CT in the Assessment of Pancreatitis Severity: An Institutional Study.
DOI: https://doi.org/10.36478/makrjms.2016.6.765.770
URL: https://www.makhillpublications.co/view-article/1815-9346/makrjms.2016.6.765.770