Riya Jeeson1, Abishek Balachandran2
BACKGROUND
The aim of this study is to evaluate the role of Multidetector Computed Tomography (MDCT) in evaluation of pancreatic lesions.
MATERIALS AND METHODS
The study included 50 patients with suspected pancreatic disorders who presented to BMCRI, Bangalore, over a time period
from November 2012 to November 2014. All patients underwent noncontrast CT scans using 6-slice MDCT with contrast study
as required. The radiological diagnoses were confirmed with biochemical parameters and histopathological correlation.
RESULTS
Out of 50 patients, 19 were diagnosed with acute pancreatitis, 25 with chronic pancreatitis and 6 with pancreatic neoplasms.
17 of 19 patients (89%) with acute pancreatitis had enlargement of the pancreas and 18 patients (95%) showed
peripancreatic inflammatory changes. Hence, focal/diffuse enlargement of pancreas with peripancreatic stranding was found
to be the most common finding in mild acute pancreatitis. Pleural effusion and ascites were found to be the most common
extrapancreatic complications.
Mild pancreatitis was reduced to 5%, moderate and severe pancreatitis increased to 74% and 21%, respectively under the
modified CT Severity Index (CTSI) scoring system as compared to CTSI. Few patients categorised as mild pancreatitis in CTSI
showed extrapancreatic complications resulting in upgradation to moderate and severe pancreatitis under the Modified CTSI
system.
Of the 25 cases of chronic pancreatitis, 20 out of 25 patients (80%) showed presence of intraductal and parenchymal
calcification, thus found to be the most common CT sign in chronic pancreatitis.
Of the 6 patients with pancreatic neoplasms, 4 were pancreatic adenocarcinoma, 1 serous cystadenoma and 1 solid
pseudopapillary tumour. Of the 6 cases, 3 were located in the head and uncinate process (50%) with double duct sign noted
in these cases. The head and uncinate process was the more common location for pancreatic adenocarcinoma with nonenhancing
hypoattenuating lesions being the most common presentation. Peripancreatic infiltration and vascular encasement
were seen in 2 patients. Lymphadenopathy and distant metastases were noted in all cases of adenocarcinoma.
CONCLUSION
MDCT with its faster scanning times, superior resolution and post processing techniques proved to be the imaging modality of
choice in imaging pancreatic pathologies and allowing accurate diagnosis.
