Ultrasonography in the diagnosis of acute pancreatitis keeping computed tomography as a gold standard: Multi-center study.

Abstract

Acute pancreatitis is considered as a major risk towards the health of the patient as the sudden incidence of the inflammation in the pancreas develops sufficient impacts on the physiological functionality of the adjacent tissues or the organs. Study Design: Cross-sectional study. Setting: PAF Hospital Islamabad. Period: November 2021 to February 2022. Methods: This study, conducted at PAF Hospital Islamabad, evaluated the diagnostic efficacy of ultrasound and CT imaging in 150 patients with acute pancreatitis. Following ethical approval and informed consent, patients aged 15-70 years with serum amylase levels above 400 U/L were included. Ultrasounds and CT scans were performed by experienced radiologists, and data were analyzed using MS Excel and SPSS. The study assessed sensitivity, specificity, predictive values, and diagnostic accuracy of both imaging modalities. Results were stratified by age, gender, BMI, and disease duration, with true positives and negatives identified based on consistent imaging results, ensuring a thorough evaluation of imaging effectiveness for acute pancreatitis diagnosis. Results: Patients were predominantly aged 36-55 (127 patients) and male (115 patients). USG showed limited diagnostic accuracy (37.6%) with a sensitivity of 41% and specificity of 35.1%. The study evaluated the diagnostic accuracy of ultrasound (USG) compared to CT scans in identifying acute pancreatitis. The positive predictive value (PPV) was 35%, and the negative predictive value (NPV) was 41%. With an overall diagnostic accuracy of 37.6%, the findings highlight USG’s limited reliability for diagnosing acute pancreatitis when compared to CT. The significance value was 0.072, influenced by a high rate of false positives. The results underscore the varying reliability of USG across different demographics. Conclusion: Ultrasonography (USG) shows limited reliability in diagnosing acute pancreatitis compared to CT, with a sensitivity of 41%, specificity of 35.1%, and overall accuracy of 37.6%. The high rate of false positives highlights that while USG can be a preliminary tool, CT remains essential for accurate diagnosis and effective clinical management.