Brief Article
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World J Gastroenterol. Jan 28, 2014; 20(4): 1088-1094
Published online Jan 28, 2014. doi: 10.3748/wjg.v20.i4.1088
Diagnostic value of contrast enhanced ultrasound for splenic artery complications following acute pancreatitis
Di-Ming Cai, Shyam Sundar Parajuly, Wen-Wu Ling, Yong-Zhong Li, Yan Luo
Di-Ming Cai, Shyam Sundar Parajuly, Wen-Wu Ling, Yong-Zhong Li, Yan Luo, Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Cai DM, Luo Y and Li YZ designed the study; Parajuly SS and Ling WW revised the manuscript; Cai DM wrote the manuscript.
Correspondence to: Dr. Yan Luo, Department of Ultrasound, West China Hospital, Sichuan University, No. 37, Guoxuexiang, Chengdu 610041, Sichuan Province, China. hxluoyan@126.com
Telephone: +86-28-85423192 Fax: +86-28-85422192
Received: August 22, 2013
Revised: November 1, 2013
Accepted: November 12, 2013
Published online: January 28, 2014
Abstract

AIM: To assess the value of contrast-enhanced ultrasound (CEUS) in diagnosing splenic artery complications (SACs) after acute pancreatitis (AP).

METHODS: One hundred and eighteen patients with AP were enrolled in the study. All patients were examined by CEUS and contrast-enhanced computed tomography (CECT). CECT was accepted as a gold standard for the diagnosis of SACs in AP. The diagnostic accuracy of splenic CEUS and pancreatic CEUS was compared with that of CECT. Splenic infarction was the diagnostic criterion for splenic artery embolism and local dysperfusion of the splenic parenchyma was the diagnostic criterion for splenic arterial stenosis. The incidence of splenic sub-capsular hemorrhage, splenic artery aneurysms, and splenic rupture was all lower than that of SACs.

RESULTS: Nine patients were diagnosed as having SACs after AP by CECT among the 118 patients. The patients with SACs were diagnosed with severe acute pancreatitis (SAP). Among them, 6 lesions were diagnosed as splenic artery embolism, 5 as splenic artery aneurysms, and 1 as splenic arterial stenosis. No lesion was diagnosed by pancreatic CEUS and 5 lesions were diagnosed by splenic CEUS. By splenic CEUS, 4 cases were diagnosed as splenic artery embolism and 1 as splenic arterial stenosis. The accuracy of splenic CEUS in diagnosis of SACs in SAP was 41.7% (5/12), which was higher than that of pancreatic CEUS (0%).

CONCLUSION: Splenic CEUS is a supplementary method for pancreatic CEUS in AP patients, which can decrease missed diagnosis of SACs.

Keywords: Acute pancreatitis, Severe acute pancreatitis, Contrast enhanced ultrasound, Splenic artery complications, Splenic contrast-enhanced computed tomography

Core tip: We prospectively investigated splenic contrast-enhanced ultrasound (CEUS) in diagnosis of splenic artery complications in acute pancreatitis (AP). The diagnostic yield of splenic CEUS for detecting splenic artery complications (SACs) in AP was higher than that of pancreatic CEUS. Splenic CEUS is a supplementary method for pancreatic CEUS when an AP patient needs pancreatic CEUS examination, which can decrease missed diagnosis of SACs.