ABSTRACT
The objective of this study was to determine whether nonenhancing pancreatic lesions are accurate in estimating pancreatic necrosis. Twenty-six consecutive abdominal computed tomography (CT) examinations performed over a 3-year period that met the CT criteria for pancreatic necrosis were reviewed. Follow-up CTs in three of 26 patients demonstrated pancreatic enhancement, indicating viable parenchyma, within the previously nonenhancing regions. All three patients had undergone surgical debridement in that area. Twenty-three cases demonstrated either no change or enlargement of the nonenhancing pancreatic lesions. Follow-up ranged from 1 week to 26 months. While CT is accurate in diagnosing pancreatic necrosis, lack of enhancement in CT may occasionally overestimate the extent of necrosis. Nonenhancing, viable but at-risk tissue may be present adjacent to frankly necrotic tissue. Surgical debridement may facilitate recovery of this viable tissue, which may enhance normally on follow-up CT.
Subject(s)
Pancreatitis, Acute Necrotizing/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Debridement/methods , Drainage/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pancreatitis, Acute Necrotizing/surgery , Radiographic Image Enhancement/methods , Reproducibility of Results , Time Factors , Tomography, X-Ray Computed/methodsABSTRACT
OBJECTIVE: Re-examination of routine pre-contrast computed tomography (CT) through liver. MATERIALS AND METHODS: 852 abdominal CTs including pre- and post-contrast images were retrospectively reviewed regarding detection of hepatic lesions. RESULTS: 103 cases demonstrated hepatic abnormalities. More liver lesions were identified post-contrast in 89; equal numbers were seen pre- and post-contrast in 10; more lesions were seen pre-contrast in one case. Tiny calcifications were detected only pre-contrast in three cases. CONCLUSIONS: Routine pre-contrast scanning through liver is not cost-effective.
