Some problems of clinical, laboratorial and computer tomographical diagnosis of chronic pancreatitis / Монголын Анагаах Ухаан

ABSTRACT

Introduction: The normal pancreas CT density is between +30HU to +40 HU and after contrast injection it will be increased till +60HU to +80 HU. We will determine the pancreas shape, size, structure, density, borders, calcification, and cysts by CT during the chronic pancreatitis. Goal Our research goal is to determine the clinical, laboratorial and computer tomographical diagnosis of acute pancreatitis, and to diagnose acute pancreatitis and differentiate from other diseases. Оbjectives 1. Study clinical symptoms of acute pancreatitis 2. Determine Alpha-amylase, АSАТ, АLАТ and glucose. 3.To determine the CT signs of chronic pancreatitis. 4. To modify the diagnostic criteria for differential diagnosis Materials and Methods: We made the study chart for this study and used the 46 patient’s data were collected from Department of Imaginary Diagnosis Achtan Elite Clinical hospital and Diagnostic center -“Friendship Naran” of Naran group. We used CT scan –W-4 made by Toshiba, Japan, MSCT PRESTO by Hitachi, Japan and CT Max -640 by General Electronic, USA for our study. Additionally, we used the other diagnostic analyses such are biochemistry, X-Ray of abdominal cavity, contrast X-Ray of gastrointestinal tract, abdominal ultrasound, celiacography, cytology, biopsy and surgical procedure. The average and errors of the study data has been evaluated by the common statistic methods and the Student’s t-test is applied to data probability. Results and Discussion: The 46 patients with chronic pancreatitis were enrolled in our study in CT scan of pancreas. Size of pancreas was normal in 2(6.7%±3.0), totally enlarged pancreas were in 14(30.7%±6.7), totally got smaller in 21(45.7%±7.3), partly enlarged in 9(19.6%±5.6), very bright from next organs in 31(67.4%±5.9), not bright from next organs in 15(32.6%±6.9), pancreas structure were same homogeneity in 17(36.9%±7.1), pancreas structure homogeneity were lost in 14(30.7%±6.7), some retention liquid were collected in back of stomach space in 8(17.4%±5.6), no liquid collected in back of stomach space in 38(82.6%±5.6), low density pancreas were in 11(23.9%±6.3), low density was not same in whole pancreas in 23(50% ±6.1), high density was same in whole pancreas in 7(15.2%±5.3), high density was not same in whole pancreas in 5(10.5%±4.6), density was increased after contrast injection in 12(26.1%±6.5), density was increased not same contribution after contrast injection in 34(73.9%±6.5), calcification of pancreas not detected in 30(65.2%±7.0), calcification of pancreas detected in 16(34.8.%±7.0), calcification in parenchyma were 11(23.9%±6.3), in tube 5(10.5%±4.6). The most common CT signs were that pancreas was very bright from neighbor organs in 67.4%, pancreas homogeneity was lost in 63.1%, high density was not same in whole pancreas in 73.9% during chronic pancreatitis (P<0.001). CT signs of pancreas which totally enlarged pancreas were in 30.4±6.7 and totally got smaller in 45.7%±7.3 are higher prevalence in our study than A.B.Jakobenko (2000). But pancreas was very bright from next organs in 67.4%±5.9, pancreas structure homogeneity were lost in 50.0%±6.1 and low density was not same in whole pancreas in 34.8%±7,1 calcification of pancreas calcification in parenchyma were 23.9%±6.3, in tube 10.5%±4.6 sign were close as A.B.Jakobenko (2000). Conclusions: 1. Patients showing signs of acute pancreatitis suffered from abdominal cramps for 53.0%±6.1, pain moving to left part of the abdomen for 62.1%±5.9, diarrhea, xerostomia, xeroderma, and fever. 2. During acute pancreatitis, alpha amylase, glucose, ASAT, and ALAT in blood plasma increased 1.7 times, 2.4 times, 1.9 times and 1.5 times respectively. 3. The most common CT signs were that pancreas was very bright from neighbor organs in 67.4%, pancreas homogeneity was lost in 63.1%, high density was not same in whole pancreas in 73.9% during chronic pancreatitis. 4. Diagnostic criteria of chronic panreatitis are could be the CT signs such as pancreas size, density, borders brightness of neighbor organs, the change of density after contrast injection and calcifications.