Second harmonic imaging improves trans-abdominal ultrasound detection of biliary sludge in ‘idiopathic’ pancreatitis
Article first published online: 4 FEB 2003
Alimentary Pharmacology & Therapeutics
Volume 17, Issue 3, pages 473–477, February 2003
How to Cite
Ierardi, E., Muscatiello, N., Nacchiero, M., Gentile, M., Margiotta, M., Marangi, S., De Francesco, V., Francavilla, R., Barone, M., Faleo, D., Panella, C., Francavilla, A. and Cuomo, R. (2003), Second harmonic imaging improves trans-abdominal ultrasound detection of biliary sludge in ‘idiopathic’ pancreatitis. Alimentary Pharmacology & Therapeutics, 17: 473–477. doi: 10.1046/j.1365-2036.2003.01435.x
- Issue published online: 4 FEB 2003
- Article first published online: 4 FEB 2003
- Accepted for publication 15 October 2002
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.