Abstract:
:Pancreatic fluid collections (PFCs) are seen in up to 50% of cases of acute pancreatitis. The Revised Atlanta classification categorized these collections on the basis of duration of disease and contents, whether liquid alone or a mixture of fluid and necrotic debris. Management of these different types of collections differs because of the variable quantity of debris; while patients with pseudocysts can be drained by straight-forward stent placement, walled-off necrosis requires multi-disciplinary approach. Differentiating these collections on the basis of clinical severity alone is not reliable, so imaging is primarily performed. Contrast-enhanced computed tomography is the commonly used modality for the diagnosis and assessment of proportion of solid contents in PFCs; however with certain limitations such as use of iodinated contrast material especially in renal failure patients and radiation exposure. Magnetic resonance imaging (MRI) performs better than computed tomography (CT) in characterization of pancreatic/peripancreatic fluid collections especially for quantification of solid debris and fat necrosis (seen as fat density globules), and is an alternative in those situations where CT is contraindicated. Also magnetic resonance cholangiopancreatography is highly sensitive for detecting pancreatic duct disruption and choledocholithiasis. Endoscopic ultrasound is an evolving technique with higher reproducibility for fluid-to-debris component estimation with the added advantage of being a single stage procedure for both diagnosis (solid debris delineation) and management (drainage of collection) in the same sitting. Recently role of diffusion weighted MRI and positron emission tomography/CT with (18)F-FDG labeled autologous leukocytes is also emerging for detection of infection noninvasively. Comparative studies between these imaging modalities are still limited. However we look forward to a time when this gap in literature will be fulfilled.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Dhaka N,Samanta J,Kochhar S,Kalra N,Appasani S,Manrai M,Kochhar Rdoi
10.3748/wjg.v21.i48.13403subject
Has Abstractpub_date
2015-12-28 00:00:00pages
13403-10issue
48eissn
1007-9327issn
2219-2840journal_volume
21pub_type
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pub_type: 杂志文章
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pub_type: 杂志文章,meta分析,评审
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更新日期:2006-11-28 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-08-21 00:00:00