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Comparative Study of Ultrasonography and Computed Tomography in Diagnosis of Acute Pancreatitis

Introduction: Pancreatitis is the inflammation of the Pancreas usually accompanied by abdominal pain and elevated levels of serum pancreatic enzymes with high rate of morbidity and mortality. USG provides initial radiological assessment, clue of the extent of involvement and an opportunity to evaluate other abdominal organs. CT scan provides a cross-sectional anatomy of the organ and involvement of adjacent structures. Study objective was to understand the role of CT and USG in determination of diagnosis of pancreatitis and to highlight and evaluate the cases in which USG failed to diagnose, which were helped through by CT. Material and Methods: This study was done in the department of Radio diagnosis at SSSMCRI, Ammapettai, Tamilnadu, India, over a period of two years. USG of patients was done using Mindray with curvilinear transducer, high frequency linear array transducer and Doppler probe. CT scan was done using GE 16 Slice CT scan machine. Results: Sensitivity of Ultrasonography in detecting acute pancreatitis was 88% in those patients in whom the pancreas was visualized. However, CT had a sensitivity of 100% visualization and better assessment of size. Though Ultrasonography is non-invasive, quick, inexpensive and a safe tool in diagnosis of pancreatic pathologies, it has certain limitations where pancreas may not be visualized. These limitations are overcome with the use of CT which yields more diagnostic information in the evaluation of both acute and chronic pancreatic pathologies. Conclusion: Ultrasound is the first investigation of choice in a patient suspected to have acute pancreatitis. But ultrasonography has low sensitivity owing to poor penetration of ultrasound waves in obese patients and patients with excessive bowel gas. Early stages, extra pancreatic extension and complications may not be picked up with ultrasonography. CT has better sensitivity and specificity hence CECT forms a confirmative investigation in diagnosis and staging of pancreatic pathologies.