Diagnostic Accuracy of Transabdominal Ultrasound and Computed Tomography in Chronic Pancreatitis: A Head-to-Head Comparison.
2021
Purpose Computed tomography (CT) is the most used imaging modality for
diagnosing chronic pancreatitis (CP), but advances in transabdominal ultrasound
(US) technology have given US a position as a viable alternative. We aimed to
evaluate the diagnostic accuracy of abdominal CT and pancreatic US compared to
the reference standard, a modified Mayo score. Materials and Methods CT, US, and endoscopic ultrasound (EUS) were
performed in patients referred due to suspected CP. The modified Mayo score
included EUS results, clinical presentation, and results from exocrine and
endocrine pancreatic function tests. We scored CT findings according to the
modified Cambridge classification and US findings according to the Rosemont
classification. Results In total, 73 patients were included. 53 patients (73%)
were categorized as CP and 20 (27%) as non-CP. CT and US yielded similar
sensitivities (68% and 64%, respectively) and specificities (75
and 85%, respectively) and similar areas under the receiver operating
characteristic curves for diagnosing CP. We found no significant differences
between the areas under the receiver operating characteristic curves (AUROCs)
for CT (AUROC 0.75, 95% CI 0.63–0.87) and US (AUROC 0.81,
95% CI 0.71–0.91). Conclusion We conclude that CT and US had comparable, moderate accuracy in
diagnosing CP. Neither modality had high enough sensitivity to exclude the
diagnosis as a standalone method.
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