Acute Pancreatitis: Revised Atlanta Classification and the Role of Cross-Sectional Imaging

Abstract

This article reviews the imaging findings associated with acute pancreatitis and its complications on cross-sectional imaging and discusses the role of imaging in light of this revision.

Imaging of abnormal liver function tests

“…Imaging in acute pancreatitis of less than 72 hours in duration is often unwarranted, because the diagnosis is made clinically and complications take time to manifest radiologically . When imaging is required, dual‐phase (arterial and venous) CECT is the best initial study.…”

“…When imaging is required, dual‐phase (arterial and venous) CECT is the best initial study. Acute interstitial pancreatitis is characterized by an enlarged and edematous pancreas with loss of normal fatty lobulation, peripancreatic fat stranding, edema and free fluid, although in mild pancreatitis imaging may be normal . MRCP is helpful in assessing the integrity of the pancreatic duct and is very sensitive for gallstones and other biliary pathology that may cause pancreatitis .…”

“…Acute interstitial pancreatitis is characterized by an enlarged and edematous pancreas with loss of normal fatty lobulation, peripancreatic fat stranding, edema and free fluid, although in mild pancreatitis imaging may be normal. 14,15 MRCP is helpful in assessing the integrity of the pancreatic duct and is very sensitive for gallstones and other biliary pathology that may cause pancreatitis. 15 US evaluation for pancreatitis is usually limited because the pancreas is partially or completely obscured by overlying bowel gas, although it may be useful in confirming or excluding the presence of stones or biliary dilatation.…”

Early diagnosis and severity assessment of acute pancreatitis (AP) using MR elastography (MRE) with spin‐echo echo‐planar imaging

“…The clinical course of each patient was documented from admission to discharge; all clinical and laboratory data were assembled. Calculation of APACHE‐II and BISAP scores was based on the data from the first 24 hours after admission, and SAP was defined according to the revised Atlanta classification (2012) as involving mortality, persistent organ failure (organ failure lasting more than 48 hours), and/or occurrence of local pancreatic complications that required intervention …”

“…Calculation of APACHE-II and BISAP scores was based on the data from the first 24 hours after admission, and SAP was defined according to the revised Atlanta classification (2012) as involving mortality, persistent organ failure (organ failure lasting more than 48 hours), and/or occurrence of local pancreatic complications that required intervention. 4,16 The control group included 22 age-, gender, and body mass index (BMI)-matched healthy volunteers from the nearby community, some of whom were members of the hospital staff. Individuals with previous history of pancreatitis, pancreatic mass, chronic liver disease, and alcohol or tobacco abuse were excluded from the control group.…”