The Role of Perfusion Computed Tomography as a Predictor of Pancreatic Necrosis in Acute Pancreatitis

Abstract

The article analyzes the data obtained as a result of the use of imaging methods in 35 patients with a new coronavirus infection who were treated in the infectious diseases department of the Surgut Regional Clinical Hospital. In the course of treatment in this group of patients, the appearance of symptoms of acute pancreatitis was noted. The criteria for inclusion in the study, in addition to the presence of a coronavirus infection confirmed by PCR, were a laboratory-detected increase in blood amylase and lipase. In the infectious diseases hospital, patients underwent perfusion computed tomography (PCT) when the first symptoms of acute pancreatitis appeared. Subsequently, in accordance with national recommendations, the entire group of patients underwent multislice computed tomography (MSCT) with bolus intravenous contrast on days 3–5. As a result of the complex of imaging research methods, 40 % (14 patients out of 35) showed a decrease in perfusion parameters characterizing the development of ischemic lesions of the pancreatic parenchyma. Later, in 11.4 % (in 4 patients out of 14), this was confirmed by MSCT with bolus intravenous contrast enhancement and was expressed as the formation of a site of destruction of the pancreatic parenchyma. In 60 % of cases (35 in 21 patients), there was no decrease in perfusion parameters during PCT, which was also later confirmed by contrast-enhanced computed tomography. Thus, we can conclude that perfusion computed tomography can play the role of an effective predictor of the development of necrotic changes in the pancreatic parenchyma in patients with acute pancreatitis that developed against the background of a new coronavirus infection.