Role of Computed Tomography Scan in the Evaluation of Pancreatic Lesions

Abstract

BACKGROUND Pancreatic lesions range from inflammation to malignancy and are associated with high morbidity and mortality. Imaging pancreatic lesion is challenging as pancreas is located retroperitoneally and with close proximity to bowel and major blood vessels. Abdominal pain, vomiting, and nausea are commonly reported symptoms. They are associated with high morbidity. Multi detector computed tomography (MDCT) is the modality of choice for detecting pancreatic pathology. It is highly sensitive in detecting necrosis, pancreatitis, peripancreatic fluid collections, calcification, neoplasm, pancreatic enlargement, atrophy and cystic lesions of pancreas. Computed tomography (CT) scan has made it possible to identify and detect various benign and malignant pancreatic lesions. METHODS A prospective observational study of 180 patients with complaints suggestive of pancreatic disease was done based on clinical, laboratory and ultrasonography in the Department of Radiodiagnosis, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe). Siemens Somatom 16 slice CT scan machine was used. All 180 patients underwent plain and contrast enhanced CT scan. RESULTS Out of 180 study participants 105 (58.33 %) were with acute pancreatitis followed by 43 (23.89 %) with chronic pancreatitis, 21 (11.67 %) with acute exacerbation of chronic pancreatitis, 10 (5.56 %) participants with carcinoma pancreas and 1 (0.56 %) participant with pancreatic injury participated in the study. CONCLUSIONS Contrast enhanced computed tomography (CECT) is an excellent diagnostic modality to stage severity of inflammatory process, staging of neoplastic lesions and traumatic injury. It is most accurate and affordable non-invasive imaging modality for the evaluation of pancreatic lesions. It is a standard investigation to identify and quantify distribution of various pancreatic lesions and also evaluates activeness and progression of disease. Thus, it helps in accurate diagnosis and characterization of lesion and in proper treatment of patients. KEY WORDS Pancreas, Imaging, Computed Tomography