DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY IN DIAGNOSING ACUTE PANCREATITIS TAKING COMPUTED TOMOGRAPHY AS GOLD STANDARD
DOI:
https://doi.org/10.71000/pg1me553Keywords:
Acute Pancreatitis, Computed Tomography, Diagnostic Accuracy, Predictive Value, Radiology, Sensitivity, Specificity, UltrasonographyAbstract
Background: Acute pancreatitis is a frequent and potentially severe inflammatory disorder of the pancreas associated with significant morbidity and mortality. Early and accurate diagnosis is crucial to prevent complications and guide timely management. While contrast-enhanced computed tomography (CT) remains the gold standard for diagnosis, ultrasonography offers a non-invasive, readily available, and cost-effective alternative, especially in resource-limited settings.
Objective: To determine the diagnostic accuracy of ultrasonography in detecting acute pancreatitis, using contrast-enhanced CT as the gold standard.
Methods: This cross-sectional validation study was conducted at the Department of Radiology, Khyber Teaching Hospital, MTI, Peshawar, over six months. A total of 192 patients aged 18–80 years with clinical suspicion of acute pancreatitis were enrolled through non-probability consecutive sampling. Ultrasonography was performed by an experienced radiologist, followed by CT scanning for confirmation. Findings from both modalities were compared, and diagnostic parameters including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated using IBM SPSS version 25.
Results: The mean age of participants was 45.8 ± 13.2 years, with 55.2% males. Ultrasonography detected acute pancreatitis in 72 patients (37.5%), while CT confirmed 68 cases (35.4%). Comparison between modalities showed 60 true positives, 12 false positives, 8 false negatives, and 112 true negatives. Ultrasonography yielded a sensitivity of 88.2%, specificity of 90.3%, PPV of 83.3%, NPV of 93.3%, and overall diagnostic accuracy of 89.6%.
Conclusion: Ultrasonography demonstrated high diagnostic accuracy in detecting acute pancreatitis when compared with CT, supporting its role as an effective initial diagnostic modality. Its use can significantly aid early detection and management, particularly in facilities where CT access is limited.
References
Boraschi P, Giugliano L, Mercogliano G, Donati F, Romano S, Neri E. Abdominal and gastrointestinal manifestations in COVID-19 patients: Is imaging useful? World J Gastroenterol. 2021;27(26):4143-59.
Artunduaga M, Grover AS, Callahan MJ. Acute pancreatitis in children: a review with clinical perspectives to enhance imaging interpretation. Pediatr Radiol. 2021;51(11):1970-82.
Hu JX, Zhao CF, Wang SL, Tu XY, Huang WB, Chen JN, et al. Acute pancreatitis: A review of diagnosis, severity prediction and prognosis assessment from imaging technology, scoring system and artificial intelligence. World J Gastroenterol. 2023;29(37):5268-91.
Formanchuk T. Acute Pancreatitis: Radiological Detection and Clinical Significance of Pancreatic Ascites, Pleural and Parapancreatic Fluid Effusions. Prague Med Rep. 2024;125(4):309-23.
Whitcomb DC, Buchner AM, Forsmark CE. AGA Clinical Practice Update on the Epidemiology, Evaluation, and Management of Exocrine Pancreatic Insufficiency: Expert Review. Gastroenterology. 2023;165(5):1292-301.
Mukai S, Takeyama Y, Itoi T, Ikeura T, Irisawa A, Iwasaki E, et al. Clinical Practice Guidelines for post-ERCP pancreatitis 2023. Dig Endosc. 2025;37(6):573-87.
von Stade L, Rao S, Marolf AJ. Computed tomographic evaluation of pancreatic perfusion in 10 dogs with acute pancreatitis. Vet Radiol Ultrasound. 2023;64(5):823-33.
Mittal N, Oza VM, Muniraj T, Kothari TH. Diagnosis and Management of Acute Pancreatitis. Diagnostics (Basel). 2025;15(3).
Mejri A, Arfaoui K, Omri A, Rchidi J, Mseddi MA, Saad S. Gallbladder adenomyomatosis: Diagnosis and management. Int J Surg Case Rep. 2021;84:106089.
Aghdassi AA, Seidensticker M. [Imaging diagnostics in acute pancreatitis]. Internist (Berl). 2021;62(10):1044-54.
Pavlidis ET, Psarras K, Symeonidis NG, Geropoulos G, Pavlidis TE. Indications for the surgical management of pancreatic trauma: An update. World J Gastrointest Surg. 2022;14(6):538-43.
López Morales P, Ruiz Marín M, Albarracín Marín-Blázquez A. Lumen-apposing metal stent deployment failure. Rev Esp Enferm Dig. 2021;113(3):224-5.
Evola G, Vacante M, Evola FR, Reina GA, Maugeri G, Musumeci G, et al. An Overview of Acute Pancreatitis: Role of the Prediction Scores for the Assessment of Severity. Chirurgia (Bucur). 2025;120(3):314-21.
Wang Y, Liu K, Xie X, Song B. Potential role of imaging for assessing acute pancreatitis-induced acute kidney injury. Br J Radiol. 2021;94(1118):20200802.
Bikkumalla S, Chandak SR, Reddy S, Ram Sohan P, Hatewar A. Radiological and Biochemical Parameters in Assessing Acute Pancreatitis Severity: A Comprehensive Review. Cureus. 2024;16(6):e62288.
Lohse MR, Ullah K, Seda J, Thode HC, Jr., Singer AJ, Morley EJ. The role of emergency department computed tomography in early acute pancreatitis. Am J Emerg Med. 2021;48:92-5.
Singh A, Aggarwal M, Garg R, Walsh M, Stevens T, Chahal P. Spontaneous Internal Pancreatic Fistulae Complicating Acute Pancreatitis. Am J Gastroenterol. 2021;116(7):1381-6.
Iannuzzi JP, King JA, Leong JH, Quan J, Windsor JW, Tanyingoh D, et al. Global incidence of acute pancreatitis is increasing over time. Gastroenterology. 2022;162(1):122-34.
Barreto SG, Habtezion A, Gukovskaya A, Lugea A, Jeon C, Yadav D, et al. Critical thresholds: key to unlocking the door to the prevention and specific treatments for acute pancreatitis. Gut. 2021;70(1):194-203.
Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review. J Am Med Assoc. 2021;325(4):382-90.
Brizi MG, Perillo F, Cannone F, Tuzza L, Manfredi R. The role of imaging in acute pancreatitis. Radiol Med. 2021;126(8):1017-29
Irum R, Yousaf M. Diagnostic Accuracy of Ultrasonography in Diagnosing Acute Pancreatitis, Taking Computed Tomography as Gold Standard. J Sharif Med Dent Coll. 2021;7(1):30-6.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Iqra Sardar, Hina Gul, Muhammad Khadim, Ayesha Begum, Raina Gul (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
