IngentaConnect Second harmonic imaging improves trans-abdominal ultrasound detec...

Authors: Ierardi, E.¹; Muscatiello, N.²; Nacchiero, M.²; Gentile, M.¹; Margiotta, M.³; Marangi, S.³; De Francesco, V.²; Francavilla, R.⁴; Barone, M.³; Faleo, D.²; Panella, C.¹; Francavilla, A.³; Cuomo, R.⁵

Source: Alimentary Pharmacology & Therapeutics, Volume 17, Number 3, February 2003 , pp. 473-477(5)

Publisher: Blackwell Publishing

Abstract:

Summary Background

: Recently, biliary sludge has been strongly correlated with `idiopathic pancreatitis'. It is often diagnosed by trans-abdominal ultrasonography, despite the low sensitivity of this investigation. New scanners, using second harmonic imaging, may improve the quality of the echographic picture. Aim

: To verify the impact of this methodology on the detection of biliary sludge in patients with `idiopathic' pancreatitis. Methods

: Fifty patients with `idiopathic' pancreatitis observed over a 18-month period entered the study. Exclusion criteria were gall-bladder stones, polyps, clinical conditions related to biliary sludge development and haemolytic disorders. Patients were assessed blind by two operators using either conventional ultrasonography or second harmonic imaging. The parameters of diagnostic quality of both examinations were evaluated using, as the gold standard, microscopic examination of the gall-bladder content collected at endoscopy after cholecystokinin infusion. Results

: An improvement in sensitivity, specificity, efficiency and negative predictive value was obtained by second harmonic imaging compared with conventional ultrasonography. Conclusions

: Second harmonic imaging, in our experience, is a reliable non-invasive tool for the diagnosis and follow-up of biliary sludge in the course of `idiopathic' pancreatitis.

Document Type: Research article

DOI: 10.1046/j.1365-2036.2003.01435.x

Affiliations: 1: Gastroenterology Department, University of Foggia, Foggia, Italy; 2: Gastroenterology Unit, `Ospedali Riuniti', Foggia, Italy; 3: Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy; 4: Department of Paediatrics, University of Bari, Bari, Italy; 5: Hepatogastroenterology Unit, Department of Experimental Medicine, University of Napoli, Napoli, Italy

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Second harmonic imaging improves trans-abdominal ultrasound detection of biliary sludge in `idiopathic' pancreatitis