Role of conventional radiography, duplex ultrasound and MDCT in diagnosis of acute pancreatitis

Introduction & Objectives: For Acute Pancreatitis, Conventional radiography is the initial imaging modality, Ultrasonography (US) is indicated early in an acute episode, and major indications for MDCT (Multi Detector Computed Tomography) in patients with acute pancreatitis are to establish or confirm the diagnosis. Objectives were: (1) To analyse the radiographic features of acute pancreatitis on plain radiograph, considering CT as a gold standard. (2) To assess the accuracy of duplex ultrasound in the diagnosis of acute pancreatitis considering CT as a gold standard. (3) To study the MDCT features of acute pancreatitis. Materials and Methods: A prospective cross sectional study was conducted on 41 patients in B P Koirala Institute of health sciences, over the period of one year (from July 2012 to June 2013). All the patients with clinical / biochemical suspicion of acute pancreatitis were included in the study. Plain radiography, duplex US & MDCT were done and different parameters were evaluated. Results: The sensitivity of each signs on X-ray was ranging from 21.43 to 91.8 %. The sensitivity of each parameter of US in diagnosis of acute pancreatitis was ranging from66.67 to 97.3 %. Conclusion: Plain radiograph can be used as the initial imaging modality in acute pancreatitis, but not to confirm the diagnosis. Duplex US has good role in evaluating the extra-pancreatic complications of acute pancreatitis & has excellent role in evaluating the biliary status of the patient with acute pancreatitis. MDCT is indicated to grade the severity and prognostication of the disease.