ACCURACY OF CT IN ESTIMATING EXTENT OF PANCREATIC NECROSIS

The objective of this study wets to determine whether nonenhancing pan creatic lesions are accurate in estimating pancreatic necrosis, Twenty -six consecutive abdominal computed tomography (CT) examinations perfo rmed over a 3-year period that met the CT criteria ria for pancreatic necrosis were reviewed. Follow-up CTs in three of 26 patients demonstr ated pancreatic enhancement, indicating viable parenchyma, within the previously nonenhancing regions. All three patients had undergone surg ical debridement in that area. Twenty-three cases demonstrated either no change or enlargement of the nonenhancing pancreatic lesions. Follo w-up ranged from 2 week to 26 months. While CT is accurate in diagnosi ng pancreatic necrosis, lack of enhancement in CT may occasionally ove restimate the extent of necrosis. Nonenhancing, viable but at-risk tis sue may be present adjacent to frankly necrotic tissue. Surgical debri dement may facilitate recovery of this viable tissue, which may enhanc e normally on follow-up CT. (C) Elsevier Science Inc., 1997.