Ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the morphologic diagnosis of pancreatic disease.

From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis" pancreatic malignant tumor" (specificity 93%), CT and ERCP in two cases (specificity 97% each). In chronic pancreatitis specificity of US and ERCP were 100% and specificity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis.