<b>MRI of Pancreatitis and Its Complications:</b> Part 1, Acute Pancreatitis

Miller, Frank H.; Keppke, Ana L.; Dalal, Kshitij; Ly, John N.; Kamler, Vilim Alan; Sica, Gregory T.

doi:10.2214/ajr.183.6.01831637

Cited by 96 publications

(55 citation statements)

References 7 publications

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“…The use of MRI for evaluation of Crohn's disease (4,5) and appendicitis is compelling considering that most patients are young and have a greater concern for ionizing radiation-induced malignancies from CT (13)(14)(15)(16). Other intraabdominal inflammatory processes shown to be delineated by T2W FS imaging includes diverticulitis (1,17) pancreatitis (18,19), pyelonephritis (20), cholecystitis (21), and for evaluation of the acute abdomen (8,19,22).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Lauenstein

Sharma

Hughes

et al. 2008

Magnetic Resonance Imaging

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Purpose: To test the theoretical benefits of a spectral attenuated inversion-recovery (SPAIR) fat-suppression (FS) technique in clinical abdominal MRI by comparison to conventional inversion-recovery (IR) FS combined with T2-weighted (T2W) partial Fourier single shot fast spin echo (SSFSE).Materials and Methods: 1.5T MRI studies of the abdomen were performed in 28 patients with liver lesions (hemangiomas n ϭ 14; metastases n ϭ 14). T2W sequences were acquired using IR and SPAIR SSFSE. Measurements included retroperitoneal and mesenteric fat signal-to-noise (SNR) to evaluate FS; liver lesion contrast-to-noise (CNR) to evaluate bulk water signal recovery effects; and bowel wall delineation to evaluate susceptibility and physiological motion effects.Results: SPAIR-SSFSE images produce significantly improved FS and liver lesion CNR. The mean SNR of the retroperitoneal and mesenteric fat for SPAIR SSFSE was 20.5 Ϯ 10.2 (Ϯ1 SD) and 12.7 Ϯ 6.2, compared to 43.2 Ϯ 24.1 (P ϭ 0.000006) and 29.3 Ϯ 16.8 (P ϭ 0.0000005) for IR-SSFSE. SPAIR-SSFSE images produced higher CNR for both hemangiomas CNR ϭ 164 Ϯ 88 vs. 126 Ϯ 83 (P ϭ 0.00005) and metastases CNR ϭ 75 Ϯ 27 vs. 53 Ϯ 19 (P ϭ 0.007). Bowel wall visualization was significantly improved using SPAIR-SSFSE (P ϭ 0.002). Conclusion:The theoretical benefits of SPAIR over conventional IR FS translate into significant multiple improvements that can be measured on clinical abdominal MRI scans.

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Section: Discussionmentioning

confidence: 99%

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Lauenstein

Sharma

Hughes

et al. 2008

Magnetic Resonance Imaging

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“…Thus far, magnetic resonance imaging (MRI) has not been widely used in the care of patients with acute pancreatitis. While CT scan remains the primary imaging technique to evaluate patients with acute pancreatitis, recent reports have indicated that MRI has some advantages: the lack of nephrotoxicity of gadolinium as compared to an iodinated preparation used for contrast-enhanced CT scan, potential concerns regarding radiation exposure, the greater ability of MRI as compared to CT to distinguish necrosis from fluid, and the overall reliability of MRI as compared to CT scan in staging the severity of acute pancreatitis and its complications (36)(37)(38). In one study, secretin-MRCP provided accurate identification of retained bile duct stones and pancreatic duct leaks (38).…”

Section: Level Of Evidence: IIImentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,665

980

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“…However, signal changes between the pancreas and liver have been reported in a minority of patients with acute interstitial edematous pancreatitis [22] . Pancreatic interlobular septa: Acute pancreatitis can re-sult in pancreatic interlobular septal inflammation, edema, and fluid collections [7,23] . MR T2-weighted with fat-suppression images can accurately depict subtle interlobular septal abnormalities, such as threadlike hyperintense structures ( Figure 3).…”

Section: Pancreatic Patternsmentioning

confidence: 99%

“…Pancreatic hemorrhage: Pancreatic hemorrhage, also called hemorrhagic pancreatitis, is seen in 2%-5% of patients with acute pancreatitis and commonly occurs in the setting of severe forms of pancreatitis [8][9][10]23] . With conversion of hemoglobin to methemalbumin in the hemorrhagic zones, MRI shows the spotted or patchy (like "salt") ( Figure 7) or threadlike or girdle-shaped hyperintensity ( Figure 8) on T1-weighted images with fat suppression.…”

Section: Pancreatic Necrosismentioning

confidence: 99%

Magnetic resonance imaging for acute pancreatitis

Xiao¹

2010

WJR

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Acute pancreatitis is characterized by acute chemical injury of the pancreatic parenchyma and peripancreatic tissue. The increased frequency of death in acute pancreatitis is directly correlated with the degree and progress of pancreatic necrosis. Moreover, the occurrence of some local complications in acute pancreatitis, such as pancreatic hemorrhage, peripancreatic abscess or large pseudocyst, and pseudoaneurysm, could influence the choice of treatment for these patients. Magnetic resonance imaging (MRI) can be used to help evaluate the presence and degree of pancreatic necrosis, and is crucial for identifying complications of acute pancreatitis and predicting prognosis. The purpose of this article is to describe MRI techniques for acute pancreatitis, to review the spectrum of pancreatic and peripancreatic patterns, as well as to survey various complications secondary to acute pancreatitis on MRI. The role of MRI in the initial evaluation and staging of acute pancreatitis is emphasized.

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MRI of Pancreatitis and Its Complications: Part 1, Acute Pancreatitis

Cited by 96 publications

References 7 publications

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Evaluation of optimized inversion‐recovery fat‐suppression techniques for T2‐weighted abdominal MR imaging

Practice Guidelines in Acute Pancreatitis

Magnetic resonance imaging for acute pancreatitis

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