T2-weighted and dynamic enhanced MRI in acute pancreatitis: Comparison with contrast enhanced CT

• Published in: Clinical radiology Vol. 52; no. 2; pp. 109 - 114
• Main Authors: Ward, J., Chalmers, A.G., Guthrie, A.J., Larvin, M., Robinson, P.J.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.02.1997; Elsevier
• Subjects: Acute Disease; Adult; Aged; Biological and medical sciences; Contrast Media; Female; Gadolinium; Gadolinium DTPA; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Organometallic Compounds; Other diseases. Semiology; Pancreatitis - diagnosis; Pancreatitis - diagnostic imaging; Pentetic Acid - analogs & derivatives; Single-Blind Method; Tomography, X-Ray Computed; Human; Evaluation; Radiodiagnosis; Acute; Characteristic; Pancreatitis; Enhancement factor; Nuclear magnetic resonance imaging; Association; Dynamic height; Digestive diseases; Medical imagery; Computerized axial tomography; Comparative study; Pancreatic disease; Image contrast
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(97)80102-X

The purpose of this study was to compare T2-weighted and dynamic contrast enhanced MRI with contrast enhanced CT in patients with severe acute pancreatitis. Thirty-two patients were examined using axial T2-weighted spin-echo imaging (TR 1801, TE 15/90) and a multi-slice rapid gradient-echo sequence (TR 135, TE 4, FA 80°) (FLASH) in axial and coronal planes. Fifteen 5 mm axial slices at 10 mm intervals were acquired during a single breath-hold of 19 s before, and at 10 and 40 s after a bolus injection of Gd-DTPA. Additional FLASH images in the coronal plane were obtained 2 min after injection of contrast medium. MR was compared with contemporary enhanced CT by two blinded observers who secored pancreatic viability and the content of intra and extra-pancreatic fluid collections. The presence of gas, calcification and haemorrhage was noted. Abnormalities in adjacent organs, evidence of vascular occlusion and indicators of aetiology were also recorded. MR and CT were concordant in distinguishing viable pancreatic tissue from areas of necrosis. MR appeared to be more effective than CT in characterizing the content of fluid collections and in demonstrating gall stones, although CT remains superior in detecting flecks of gas and calcification. MR carries some advantages over CT and can be regarded as an alternative primary technique in patients with severe pancreatitis.