Department of Sonography, West China Hospital, Sichuan University, 610041, Chengdu, China.
Dig Dis Sci. 2011 May;56(5):1578-84. doi: 10.1007/s10620-010-1460-6. Epub 2010 Nov 28.
To investigate the ability of contrast-enhanced ultrasound (CEUS) in the assessment of acute pancreatitis (AP), as well as its diagnostic accuracy in the evaluation of the severity of pancreatitis.
A prospective double-blind study was carried out in 33 AP patients from May 2007 to January 2008. Each patient underwent both CEUS and contrast-enhanced computed tomography (CECT) with the time interval between two examinations less than 72 h. Using CECT as gold standard, the ability of CEUS to diagnose pancreatic necrosis as well as peripancreatic effusion and/or complications, and its diagnostic value in the evaluation of the severity of pancreatitis, were investigated. Balthazar's grading system was used to measure CT and ultrasound severity indices (CTSI and USSI), and the correlation between CTSI and USSI was tested by Spearman's rank correlation coefficient.
A strong correlation between CTSI and USSI was found (r = 0.92, P < 0.01).The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS in the diagnosis of pancreatic parenchyma necrosis were 90, 95, 94, 90 and 95%, in the diagnosis of peripancreatic effusion and/or complications were 83, 100, 93, 100 and 91%, and in the diagnosis of severe pancreatitis were 97, 67, 94, 97 and 67%, respectively.
CEUS has shown to be of clinical value in the assessment of pancreatic necrosis as well as peripancreatic complications in AP and has a high diagnostic accuracy in the evaluation of the severity of pancreatitis. Further studies are needed to add it to the diagnostic algorithm for acute pancreatitis.
探讨超声造影（CEUS）在急性胰腺炎（AP）评估中的应用价值及其对胰腺炎严重程度评估的诊断准确性。
前瞻性双盲研究，2007 年 5 月至 2008 年 1 月对 33 例 AP 患者进行研究。所有患者均在 72 h 内行 CEUS 和增强 CT（CECT）检查。以 CECT 为金标准，评估 CEUS 对胰腺坏死、胰周积液和/或并发症的诊断能力，及其对胰腺炎严重程度评估的诊断价值。采用 Balthazar 分级系统测量 CT 和超声严重指数（CTSI 和 USSI），采用 Spearman 秩相关系数检验 CTSI 和 USSI 之间的相关性。
CTSI 与 USSI 之间具有高度相关性（r = 0.92，P < 0.01）。CEUS 诊断胰腺实质坏死的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为 90%、95%、94%、90%和 95%，诊断胰周积液和/或并发症的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为 83%、100%、93%、100%和 91%，诊断重症胰腺炎的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为 97%、67%、94%、97%和 67%。
CEUS 对 AP 胰腺坏死和胰周并发症的评估具有临床价值，对胰腺炎严重程度的评估具有较高的诊断准确性。需要进一步研究以将其纳入急性胰腺炎的诊断算法中。
