From: Appraisal of the diagnostic procedures of acute pancreatitis in the guidelines
Guideline | Reference standard | Ar [2] | Li [3] | Jo [4] | Ma [5] | AI [6] | GS [7] | PD [8] |
---|---|---|---|---|---|---|---|---|
(1) Primary diagnosis of AP | ||||||||
Symptoms and signs | Abdominal pain (acute onset of a persistent, severe, epigastric pain often radiating to the back) | – | 80–100% | – | – | – | 80–100% | 80–100% |
Biochemical evidence | Serum lipase activity (or amylase) at least 3 times greater than the upper limit of normal | – | 80–100% | 80–100% | 80–100% | – | 80–100% | 80–100% |
Characteristic findings from abdominal imaging | Characteristic findings of acute pancreatitis on ultrasound, computed tomography or magnetic resonance imaging | – | 80–100% | 80–100% | 80–100% | – | 80–100% | 80–100% |
(2) Classification of the severity of AP | ||||||||
Classification tools | Revised Atlanta Classification | – | 80–100% | 80–100% | – | – | 80–100% | 80–100% |
C-reactive Protein(CRP) level ≥ 150 mg/l | – | 40–60% | 80–100% | – | – | – | 80–100% | |
APACHE-II score | – | 80–100% | 80–100% | – | – | 80–100% | 80–100% | |
(3) Etiological diagnosis of AP | ||||||||
Ultrasound (US) / endoscopic ultrasound (EUS) | – | 80–100% | 80–100% | 80–100% | 20–40% | 40–60% | 80–100% | |
Magnetic resonance imaging (MRI) / Magnetic resonance cholangiopancreatography (MRCP) | – | 80–100% | 80–100% | 80–100% | 80–100% | – | 80–100% | |
Endoscopic retrograde cholangiopancreatography (ERCP) | – | 80–100% | 80–100% | 80–100% | – | – | 80–100% | |
(4) Diagnosis of comorbidities of AP | ||||||||
pancreatic necrosis/ abdominal fluid collection/pseudocyst / walled-off necrosis (WoN) | CE-CT | – | 80–100% | 40–60% | 80–100% | 80–100% | 80–100% | 80–100% |
Infected collection, necrosis or WoN | Fine needle aspiration (FNA) | – | 80–100% | 80–100% | 80–100% | 80–100% | 80–100% | 20–40% |