Yamamiya Akira, Kitamura Katsuya, Yoshida Hitoshi, Ishii Yu, Mitsui Yuta, Irisawa Atsushi
Department of Gastroenterology, Dokkyo Medical University School of Medicine, Mibu, Japan.
Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
J Hepatobiliary Pancreat Sci. 2020 Oct;27(10):739-746. doi: 10.1002/jhbp.803. Epub 2020 Aug 6.
BACKGROUND/PURPOSE: This study investigated whether measuring pancreatic blood volume (PBV) on whole pancreatic perfusion computed tomography (P-CT) can predict the progression of walled-off necrosis (WON) in patients with acute pancreatitis (AP).
A single-center, retrospective cohort study was conducted between December 2015 and December 2016. The participants were divided into two groups: 14 patients with WON and 15 patients without WON. PBV was measured within 72 hours after the diagnosis of AP, and the final diagnosis of WON was made by contrast-enhanced CT (CE-CT) or endoscopic ultrasonography (EUS) 4 weeks after the onset of AP.
The minimum CT value did not differ significantly between the two groups. On the other hand, the minimum PBV was significantly lower in the WON group than in the without WON group (1.4 (0.9-9.9) vs 19.8 (8.2-21.7) mL/100 mL, respectively; P = .02). The cutoff value of the minimum PBV for WON was 16.5 mL/100 mL (sensitivity 100%, specificity 67%, AUC 0.85; P = .001).
Whole pancreatic P-CT can evaluate pancreatic ischemia visually and quantitatively. The minimum PBV measurement on whole pancreatic P-CT within 72 hours after the diagnosis of AP contributes to the prediction of progression of WON.
背景/目的：本研究调查了在全胰腺灌注计算机断层扫描（P-CT）上测量胰腺血容量（PBV）是否可预测急性胰腺炎（AP）患者壁内坏死（WON）的进展。
于2015年12月至2016年12月进行了一项单中心回顾性队列研究。参与者分为两组：14例WON患者和15例非WON患者。在AP诊断后72小时内测量PBV，并在AP发病4周后通过对比增强CT（CE-CT）或内镜超声（EUS）做出WON的最终诊断。
两组之间的最小CT值无显著差异。另一方面，WON组的最小PBV显著低于非WON组（分别为1.4（0.9 - 9.9）与19.8（8.2 - 21.7）mL/100 mL；P = 0.02）。WON的最小PBV临界值为16.5 mL/100 mL（敏感性100%，特异性67%，AUC 0.85；P = 0.001）。
全胰腺P-CT可直观且定量地评估胰腺缺血。在AP诊断后72小时内对全胰腺P-CT进行最小PBV测量有助于预测WON的进展。
