Standard criteria versus Rosemont classification for EUS-diagnosis of chronic pancreatitis.
OBJECTIVE
to study the possible differences in the final diagnosis of chronic pancreatitis by using standard classification described by Wiersema et al. and the new classification proposed recently by Rosemont.


METHODS
forty-seven patients with the diagnosis of chronic pancreatitis were included in this study. The parenchymal and ductal criteria were studied, the patients were divided in two groups for Wiersema criteria: < 4 criteria, non-diagnostic for chronic pancreatitis and ≥ 4 criteria, diagnosis of chronic pancreatitis. The same patients were divided in four groups according to Rosemont classification: normal pancreas, indeterminate, suggestive and consistent with chronic pancreatitis. We analyzed these data with Chisquare test reported with 95% confidence intervals (CI).


RESULTS
in patients with chronic pancreatitis the most frequent criteria observed were lobularity in 66% of cases and pancreatic duct dilatation and calcifications in 57.4% of cases each. We found a significant statistical association between the results of both classifications (p < 0.05). The highest association is found in patients with more than 4 standard criteria and definitive diagnostic of chronic pancreatitis according to Rosemont classification. In patients who have less than 4 standard criteria the diagnosis is suggestive of chronic pancreatitis by using the Rosemont classification in 27.66% (p < 0.05).


CONCLUSIONS
these results show that no significant statistical differences are found for patients with > 4 criteria diagnosis by standard criteria. But 27.66% patients with less than 4 standard criteria would be suggestive according to Rosemont classification (p < 0.05). Hence, the new classification would be useful in patients with high suspicion of chronic pancreatitis with < 4 standard criteria but with more significance such as parenchymal lithiasis, lobularity or ductal calcifications.
Division of Digestive Diseases, Unit of Endoscopy, Hospital General Virgen de la Luz, Cuenca, Spain. cjimenoayllon@yahoo.es
Cristina
C
Jimeno-Ayllón
José Ignacio
JI
Pérez-García
Carmen Julia
CJ
Gómez-Ruiz
Jesús
J
García-Cano-Lizcano
Julia
J
Morillas-Ariño
Raquel
R
Martínez-Fernández
Lorena
L
Serrano-Sánchez
Ángel
Á
Pérez-Sola
D000328:Adult; D000368:Aged; D000465:Algorithms; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D016292:Procedural Sedation; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D019160:Endosonography; D005260:Female; D006801:Humans; D020347:Lithiasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000145:classification / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012307:Risk Factors; D014741:Video Recording