Pancreatitis is defined as the inflammation of the pancreas and considered the most common pancreatic disease in children and adults. Imaging plays a significant role in the diagnosis, severity assessment, recognition of complications and guiding therapeutic interventions. In the setting of pancreatitis, wider availability and good image quality make multi-detector contrast-enhanced computed tomography (MD-CECT) the most used imaging technique. However, magnetic resonance imaging (MRI) offers diagnostic capabilities similar to those of CT, with additional intrinsic advantages including lack of ionizing radiation and exquisite soft tissue characterization. This article reviews the proposed definitions of revised Atlanta classification for acute pancreatitis, illustrates a wide range of morphologic pancreatic parenchymal and associated peripancreatic changes for different types of acute pancreatitis. It also describes the spectrum of early and late chronic pancreatitis imaging findings and illustrates some of the less common types of chronic pancreatitis, with special emphasis on the role of CT and MRI.
Over the past two decades, advances in cross-sectional imaging such as computed tomography and magnetic resonance imaging (MRI) have dramatically changed the concept of gastrointestinal imaging. MR is playing an increasing role in the evaluation of gastrointestinal disorders. MRI combines the advantages of excellent soft-tissue contrast, noninvasiveness, functional information and lack of ionizing radiation. Furthermore, recent developments of MRI have led to improved spatial and temporal resolution as well as decreased motion artifacts. In this article we describe the technical aspects of gastrointestinal MRI and present a practical approach for a well-known spectrum of gastrointestinal disease processes.
This study was performed to evaluate the prevalence of thickened carotid intima media thickness (CIMT) in a Sri Lankan cohort of lupus nephritis (LN) patients and to identify associations between traditional cardiovascular disease (CVD) and LN-related risk factors with increased CIMT. Consecutive patients with biopsy-proven LN were evaluated for conventional CVD risk factors, renal parameters and extent of organ involvement in this cross-sectional study. Current disease activity and damage were assessed by the British Isles Lupus Activity Group (BILAG) score and the Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) damage index, respectively. CIMT was assessed by B Mode grey scale ultrasonography. Increased CIMT was defined as CIMT more than the 75th percentile based on cutoffs from the "Carotid Atherosclerosis Progression Study." Forty patients (98% female), with a mean age of 38 years (age range of 20-50) and of South Asian descent, were evaluated. The mean duration of disease of 6.15 years (SD = 4.66). The overall prevalence of cardiovascular events was low and included previous acute coronary syndromes in 7.5%, stable angina in 5%, cerebrovascular accidents in 7.5% and transient ischemic attacks in 2.5% of the patients; 72.5% had hypertension (HTN) [mean blood pressure (BP) 140/80 mm Hg]; 32.5% had dyslipidemias (mean serum cholesterol 5.9; SD = 5.6) and 25% had diabetes (mean blood sugar 103.7; SD = 15.6). Forty percent were obese and 20% were overweight (Asian cutoffs). Increased CIMT (57.5%) and atherosclerotic plaques (15.36%) indicated a high CVD risk in this cohort. Diabetes (P = 0.016), HTN (P = 0.002), dyslipidemia (P = 0.002) and obesity (P = 0.048) were associated with thickened CIMT. The only LN-related risk factor associated with thickened CIMT (P <0.05) was the SLICC/ACR damage index. The independent predictors of thickened CIMT determined by logistic regression analysis were HTN and dyslipidemia.
Background Systemic lupus erythematosus (SLE) is associated with a high risk of cardiovascular disease (CVD). In addition to traditional risk factors, SLE disease related factors such as renal dysfunction are postulated to confer an increased CVD risk (1). Objectives To correlate conventional CVD risk factors and lupus nephritis (LN) related risk factors in a cohort of LN patients using carotid intimal-media thickenss (CIMT) as a surrogate measure of CVD risk. Methods Consecutive patients (n=40, of which n=38 were female) were recruited from the university research clinic, National Hospital Sri Lanka. The patients were evaluated for conventional CVD risk factors, renal parameters and extent of organ involvement. Current disease activity and damage were assessed by the BILAG score and SLICC/ACR damage index respectively. CIMT was assessed by B Mode grey scale ultasonography. Results The mean age was 31 years (SD=8.87) with the average age at SLE diagnosis being 25 years (SD=6.7). Of these patients, 25% had neuropsychiatric manifestations, 87.5% had muco-cutaneous involvement, 20% had serositis, 47.5% had haematological involvement and 90% had arthritis. Previous acute coronary syndromes (7.5%), stable angina (5%), cerebrovascular accidents (7.5%), transient ischaemic attacks (2.5%), lower limb claudication(5%) and digital gangrene(5%) were documented. There were no current or ex-smokers. 72.5% had hypertension, 32.5% had dyslipidemias and 25% had diabetes. 40% were obese and 20% overweight (Asian cutoffs). 30% had elevated CRP. The LN patients were in Class I- 2.5%, II-12.5%, III-20%, IV-60%, V-5%. Nephrotic range proteinuria was present in 32% and chronic kidney disease (CKD) was present in 52% of patients (Stage 1 – 35%, Stage 2 – 43%, Stage 3 – 24%). CIMT was considered increased if more than the 75th percentile based on cutoffs from the “Carotid Atherosclerosis Progression Study”. Increased CIMT (57.5%) and atherosclerotic plaques (15 36%) indicate a high CVD risk in this cohort. Diabetes (p=0.016), hypertension (p=0.002), dyslipdemia (p=0.002) and obesity (p=0.048) independently correlated with increased CIMT. Increased CIMT and plaques were not associated with high CRP or high current disease activity. A higher CIMT was observed with a significantly high cardiovascular (p=0.018) and peripheral vascular index (p=0.016) but not withproteinuria >3.5g/24h or estimated GFR<50% on the SLICC/ACR. Previous coronary disease (p=0.043) and atherosclerotic plaques (p=0.038) were significantly associated with nephrotic syndrome in univariate analysis but not with multivariate logistic regression which included conventional CVD risk factors. Conclusions This LN cohort had varied organ involvement and a high prevalence of conventional CVD risk factors. Nephrotic range proteinuria and CKD did not confer an independently increased risk of CVD in cohort. The increased CVD risk prevalent was attributed to increased prevalence of conventional risk factors. References Sazliyana S et al. Implications of immunosuppressive age...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.