Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio
Background Acute pancreatitis is a reversible inflammation of the pancreatic parenchyma. Enlargement of the pancreas is often envisaged in such conditions. This study evaluates P/V ratio, as a marker to decide pancreatic enlargement in disease condition. Purpose The aim of this study was...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2022-12-01
|
| Series: | Indian Journal of Radiology and Imaging |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754368 |
| _version_ | 1797987015603519488 |
|---|---|
| author | Dhanraj S. Raut Shubhangi A. Desai Dhananjay V. Raje Dinesh Singh Vithalrao P. Dandge |
| author_facet | Dhanraj S. Raut Shubhangi A. Desai Dhananjay V. Raje Dinesh Singh Vithalrao P. Dandge |
| author_sort | Dhanraj S. Raut |
| collection | DOAJ |
| description | Background Acute pancreatitis is a reversible inflammation of the pancreatic parenchyma. Enlargement of the pancreas is often envisaged in such conditions. This study evaluates P/V ratio, as a marker to decide pancreatic enlargement in disease condition.
Purpose The aim of this study was to develop imaging-based diagnostic criterion for acute pancreatitis in children based on P/V ratio.
Material and Methods This study included 37 children with acute pancreatitis and 283 children asymptomatic for pancreatic disorders, from a single hospital center. The age of children ranged between 2 and 18 years. P/V ratio, which is the ratio of greatest anteroposterior dimension of the head, body, and tail of the pancreas relative to the transverse lumbar vertebral body, was obtained for each child through ultrasonographic examination. Age-adjusted receiver operating characteristics (AROC) analysis was performed on P/V ratio at presentation for each pancreatic region, and the sensitivity at 90% specificity, the threshold errors, and the corresponding cutoffs were obtained. The enlargement assessment was also done after clinical recovery by referring to the cutoffs of respective regions.
Results AROC analysis for males and females resulted into a maximum sensitivity of 83.33 and 81.67%, respectively, at 90% specificity for head. The error thresholds for both the groups were same, i.e., 0.098, indicating that 90% of the observations had errors less than the threshold. The corresponding P/V ratio cutoff for males and females was 0.43 and 0.42, respectively.
Conclusion Radiologists and clinicians can refer a cutoff value of 0.4 for each region, along with hypoechogenicity, to decide about enlargement of the pancreas in acute pancreatitis condition. |
| first_indexed | 2024-04-11T07:42:11Z |
| format | Article |
| id | doaj.art-c2fb3c56e45143a8bc3a05f315810a8b |
| institution | Directory Open Access Journal |
| issn | 0971-3026 1998-3808 |
| language | English |
| last_indexed | 2024-04-11T07:42:11Z |
| publishDate | 2022-12-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Radiology and Imaging |
| spelling | doaj.art-c2fb3c56e45143a8bc3a05f315810a8b2022-12-22T04:36:31ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Radiology and Imaging0971-30261998-38082022-12-01320448849610.1055/s-0042-1754368Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V RatioDhanraj S. Raut0Shubhangi A. Desai1Dhananjay V. Raje2Dinesh Singh3Vithalrao P. Dandge4Department of Pediatrics, NKP Salve Institute of Medical Sciences, Nagpur, Maharashtra, IndiaBio-Analytics Pvt. Ltd., Mumbai, Maharashtra, IndiaBio-Analytics Pvt. Ltd., Mumbai, Maharashtra, IndiaSpiral CT Scan and Diagnostic Center, Nagpur, Maharashtra, IndiaGardi Medical College, Ujjain, Madhya Pradesh, IndiaBackground Acute pancreatitis is a reversible inflammation of the pancreatic parenchyma. Enlargement of the pancreas is often envisaged in such conditions. This study evaluates P/V ratio, as a marker to decide pancreatic enlargement in disease condition. Purpose The aim of this study was to develop imaging-based diagnostic criterion for acute pancreatitis in children based on P/V ratio. Material and Methods This study included 37 children with acute pancreatitis and 283 children asymptomatic for pancreatic disorders, from a single hospital center. The age of children ranged between 2 and 18 years. P/V ratio, which is the ratio of greatest anteroposterior dimension of the head, body, and tail of the pancreas relative to the transverse lumbar vertebral body, was obtained for each child through ultrasonographic examination. Age-adjusted receiver operating characteristics (AROC) analysis was performed on P/V ratio at presentation for each pancreatic region, and the sensitivity at 90% specificity, the threshold errors, and the corresponding cutoffs were obtained. The enlargement assessment was also done after clinical recovery by referring to the cutoffs of respective regions. Results AROC analysis for males and females resulted into a maximum sensitivity of 83.33 and 81.67%, respectively, at 90% specificity for head. The error thresholds for both the groups were same, i.e., 0.098, indicating that 90% of the observations had errors less than the threshold. The corresponding P/V ratio cutoff for males and females was 0.43 and 0.42, respectively. Conclusion Radiologists and clinicians can refer a cutoff value of 0.4 for each region, along with hypoechogenicity, to decide about enlargement of the pancreas in acute pancreatitis condition.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754368acute pancreatitisacute recurrent pancreatitisage-adjusted receiver operating characteristicsanteroposterior |
| spellingShingle | Dhanraj S. Raut Shubhangi A. Desai Dhananjay V. Raje Dinesh Singh Vithalrao P. Dandge Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio Indian Journal of Radiology and Imaging acute pancreatitis acute recurrent pancreatitis age-adjusted receiver operating characteristics anteroposterior |
| title | Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio |
| title_full | Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio |
| title_fullStr | Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio |
| title_full_unstemmed | Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio |
| title_short | Enlargement of the Pancreas in Children Diagnosed with Acute Pancreatitis: An Approach Based on P/V Ratio |
| title_sort | enlargement of the pancreas in children diagnosed with acute pancreatitis an approach based on p v ratio |
| topic | acute pancreatitis acute recurrent pancreatitis age-adjusted receiver operating characteristics anteroposterior |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0042-1754368 |
| work_keys_str_mv | AT dhanrajsraut enlargementofthepancreasinchildrendiagnosedwithacutepancreatitisanapproachbasedonpvratio AT shubhangiadesai enlargementofthepancreasinchildrendiagnosedwithacutepancreatitisanapproachbasedonpvratio AT dhananjayvraje enlargementofthepancreasinchildrendiagnosedwithacutepancreatitisanapproachbasedonpvratio AT dineshsingh enlargementofthepancreasinchildrendiagnosedwithacutepancreatitisanapproachbasedonpvratio AT vithalraopdandge enlargementofthepancreasinchildrendiagnosedwithacutepancreatitisanapproachbasedonpvratio |