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Khirurgii

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Year 2014 Vol. 22 No 1

GENERAL AND SPECIAL SURGERY

Y.S. VINNIK, S.S. DUNAEVSKAYA, D.A. ANTUFRIEVA

POSSIBILITY OF THE CURRENT METHODS OF VISUALIZATION AT SEVERE ACUTE PANCREATITIS

SBEE HPE “Krasnoyarsk State Medical
University named after prof. V.F.
Voyno-Yasenetsky”
The Russian Federation

Objectives. To determine effectiveness of application of ultrasonography (US), CT-angiography and magnetic resonance imaging (MRI) in diagnosis of severe acute pancreatitis in the enzymatic stage of the disease.
Methods. 30 patients with diagnosis of a severe acute pancreatitis in the enzymatic stage of the disease have been studied. The age of patients varied between 23 and 76 years. The patients were carried out US of the abdominal cavity organs, CT-angiography with contrast bolus and MRI with contrast in the period between 24 and 48 hour after hospitalization. All patients (abdominal organs) were scanned by B-mode Ultrasonography with Aloka product (model SSD-3500) Ultrasound diagnostic system equipped with 3,5 MHz transducer. As the peculiarity of the conduction of CT-angiography is the performance of a 3-phase scan: native (contrast free), arterial and venous. The delay of scanning start for obtaining the arterial phase was determined automatically according to the program Bolus tracking.
A series of images in the coronal and axial planes in T1VI and T2VI has been performed in MRI and MR cholangiography. The recommended dosage of MAGNEVIST injection is 0,2 ml/kg.
To assess diagnostic methods of efficacy the following parameters have been calculated: sensitivity, specificity, accuracy, prognostic value of a positive result (PVPR), prognostic value of a negative result (PVNR).
Results. While determining efficacy of the visualization methods at severe acute pancreatitis US sensitivity was made – 50%, specificity – 20,0%, accuracy – 37,1%, PVPR – 45,5%, PVNR – 23,1%. While establishing MRI effectiveness sensitivity made up 86,9%, specificity – 100%%, accuracy – 90%, PVPR – 100%, PVNR – 70%.
Conclusions. CT-angiography and MRI revealed no reliable diagnostic distinctions. The more clearly visualization of infiltration sites and collection of fluid in the peritoneal cavity are considered to be the advantages of MRI with contrast. Ultrasonography appears to be not able to provide the clearly visualization of lesion volume, however, is considered to be relevant as a screening method.

Keywords: acute pancreatitis, diagnostics, visualization, severe course
p. 58 – 62 of the original issue
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Address for correspondence:
660022, Rossiiskaia Federatsiia, g. Krasnoiarsk, ul. Partizana Zhelezniaka, d. 1, GBOU VPO «Krasnoiarskii gosudarstvennyi meditsinskii universitet im. prof. V.F. Voino-Iasenetskogo», kafedra obshchei khirurgii,
e-mail: Vikto-potapenk@yandex.ru,
Dunaevskaya Svetlana Sergeevna
Information about the authors:
Vinnick Y.U. MD, a head of the chair of general surgery of SEI HPE "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky".
Dunaevskaya S.S. PhD, an associate professor of the chair of general surgery of SEI HPE "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky."
Antyufrieva D.A. A clinical resident of a chair of general surgery of SEI HPE "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky."
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