@article{MAKHILLRJMS201610631871,
    title = {Comparative Evaluation of Ultrasound and CT in the Assessment of Pancreatitis Severity: An Institutional Study},
    journal = {Research Journal of Medical Sciences},
    volume = {10},
    number = {6},
    pages = {765-770},
    year = {2016},
    issn = {1815-9346},
    doi = {makrjms.2016.6.765.770},
    url = {https://makhillpublications.co/view-article.php?issn=1815-9346&doi=makrjms.2016.6.765.770},
    author = {K. and},
    keywords = {Acute pancreatitis, ultrasound, computed tomography, MCTSI, Revised Atlanta classification, diagnostic accuracy, Cohen’s kappa, chi‐square},
    abstract = {<p>Acute &nbsp;pancreatitis &nbsp;spans &nbsp;mild &nbsp;edema &nbsp;to &nbsp;necrosis &nbsp;with &nbsp;organ &nbsp;failure. We &nbsp; compared &nbsp; routine &nbsp; transabdominal &nbsp; ultrasound &nbsp; (US) &nbsp; with contrast-enhanced CT (CECT) for key findings and severity grading using MCTSI and Revised Atlanta categories. Prospective single-center study, n=75. All patients had baseline US and CECT at 48-72 h. Two blinded radiologists assessed enlargement, inflammatory changes, peripancreatic collections, ascites, biliary pathology, and vascular involvement; severity graded by MCTSI. Statistics: proportions, sensitivity/specificity/PPV/NPV (US vs CT), Cohen&rsquo;s &kappa; (including weighted &kappa; for severity), and &chi;&sup2; for association of clinical (Atlanta) vs imaging severity. Detection (US vs CT): enlargement 77.3% vs 82.7%; inflammatory changes 80.0% vs 86.7%; collections 53.3% vs 50.7%; ascites 29.3% vs 26.7%; biliary pathology 37.3% vs 40.0%; vascular 8.0% vs 9.3%. US performance: collections 84.2%/90.0%, ascites 88.9%/96.4%, biliary 93.3%/91.0%, vascular 71.4%/97.0% (sensitivity/specificity). Agreement (&kappa;): enlargement 0.72, inflammation 0.69, collections 0.76, ascites 0.80, biliary 0.78, vascular 0.55. MCTSI: mild 37.3%, moderate 40.0%, severe 22.7%. US severity showed moderate&ndash;good concordance with CT (weighted &kappa;&asymp;0.64&ndash;0.71). Clinical severity correlated with CT severity (&chi;&sup2;=26.87, df=4, p&lt;0.001). US reliably identifies biliary pathology, ascites, and larger collections with good concordance to CT, but CT remains essential for definitive severity grading and detecting necrosis/vascular complications. Pragmatic pathway: early US for triage and etiology, followed by timed CT for comprehensive severity assessment.</p>
}
    }