Detection of severe acute pancreatitis by contrast-enhanced magnetic resonance imaging

The aim of the study was to assess the ability of MRI to differentiate between the two forms of severity of acute pancreatitis (AP), which is important for the detection of patients who require intensive monitoring and therapy. The second objective was to evaluate whether the distinction would be po...

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Published inEuropean radiology Vol. 10; no. 2; pp. 354 - 361
Main Authors Piironen, A, Kivisaari, R, Kemppainen, E, Laippala, P, Koivisto, A M, Poutanen, V P, Kivisaari, L
Format Journal Article
LanguageEnglish
Published Germany Springer Nature B.V 01.01.2000
Subjects
Acute Disease
Adult
Case-Control Studies
Cells
Chelates
Classification systems
Contrast Media
Female
Gadolinium
Gadolinium DTPA
Humans
Intravenous administration
Magnetic fields
Magnetic Resonance Imaging
Male
Pancreas
Pancreatitis
Pancreatitis - diagnosis
Prospective Studies
SAP protein
Severity of Illness Index
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Summary:The aim of the study was to assess the ability of MRI to differentiate between the two forms of severity of acute pancreatitis (AP), which is important for the detection of patients who require intensive monitoring and therapy. The second objective was to evaluate whether the distinction would be possible regardless of the MRI equipment. Magnetic resonance imaging was performed before and after intravenous administration of a gadolinium (Gd) chelate at 1.0 T using the breath-hold multislice rapid gradient-echo turbo fast low-angle shot (FLASH) sequence in 14 patients, and at 1.5 T with the 2D FLASH(50) sequence with fat saturation in 18 patients with acute pancreatitis early in the course of the disease. The patients were classified according to the Atlanta classification system as having the mild (MAP) or severe (SAP) form of the disease. At 1.0 T with use of a body coil, contrast-enhanced MRI failed to distinguish mild from severe pancreatitis. At 1.5 T with a phased-array body coil, the signal intensities of the patients with SAP were statistically significantly lower than those of the MAP group. Our initial clinical experience suggests that MRI with a sufficient magnetic field gradient strength may be useful for separating the two forms of acute pancreatitis in their early phases.
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ISSN:0938-7994
1432-1084
DOI:10.1007/s003300050055