Diffusion-weighted magnetic resonance imaging indicates the severity of acute pancreatitis

Diffusion-weighted magnetic resonance imaging indicates the severity of acute pancreatitis

Author Tertulino, Franklin de Freitas Autor UNIFESP Google Scholar
Schraibman, Vladimir Autor UNIFESP Google Scholar
Ardengh, Jose Celso Autor UNIFESP Google Scholar
Espirito-Santo, Danilo Cerqueira do Autor UNIFESP Google Scholar
Ajzen, Sergio Aron Autor UNIFESP Google Scholar
Apodaca Torrez, Franz Robert Autor UNIFESP Google Scholar
Lobo, Edson Jose Autor UNIFESP Google Scholar
Szejnfeld, Jacob Autor UNIFESP Google Scholar
Goldman, Suzan Menasce Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Abstract Purpose: To test the use of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate between different degrees of severity of acute pancreatitis (AP).Method: Thirty-six patients who underwent DW-MRI and magnetic resonance cholangiopancreatography were divided into patients with mild AP (mAP, n = 15), patients with necrotizing AP (nAP, n = 8), and patients with a normal pancreas (nP, n = 15; controls). the pancreas was divided into head, body, and tail, and each segment was classified according to image features: pattern 1, normal; pattern 2, mild inflammation; and pattern 3, necrosis. Apparent diffusion coefficients (ADCs) were measured in each segment and correlated with clinical diagnoses.Results: A total of 108 segments was assessed (three segments per patient). Segments classified as pattern 1 in the nP and mAP groups showed similar ADC values (P = 0.29). ADC values calculated for the pancreatic segments grouped according to the different image patterns (1-3) were significantly different (P < 0.001). Comparisons revealed significant differences in signal intensity between all three patterns (P < 0.05).Conclusions: DW-MRI was a compatible and safe image option to differentiate tissue image patterns in patients with mAP, nAP, and nP, mainly in those with contrain-dications to contrast-enhanced MRI (which is classically required for determining the presence of necrosis) or computed tomography. ADC measures allowed precise differentiation between patterns 1, 2, and 3.
Keywords Acute necrotizing pancreatitis
Diffusion magnetic resonance imaging
Differential diagnosis
Language English
Date 2015-02-01
Published in Abdominal Imaging. New York: Springer, v. 40, n. 2, p. 265-271, 2015.
ISSN 0942-8925 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 265-271
Origin http://dx.doi.org/10.1007/s00261-014-0205-y
Access rights Closed access
Type Article
Web of Science ID WOS:000348298800006
URI http://repositorio.unifesp.br/handle/11600/38674

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