Acute pancreatitis MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]
Overview
Imaging using MRI has some advantages over the use of CT. One of the advantages is that there is less of a chance of contrast induced nephropathy. In additions, the organs and vessels can be visualized better, and it is easier to distinguish between mild and severe pancreatitis.
MRI
- A study showed that a nonenhanced magnetic resonance imaging (MRI) was comparable to contrast-enhanced computed tomography (CT).[1]
- While computed tomography is considered the gold standard in diagnostic imaging for acute pancreatitis,[2] magnetic resonance imaging (MRI) has become increasingly valuable as a tool for the visualization of the pancreas, particularly of pancreatic fluid collections and necrotized debris.[3]
- Additional utility of MRI includes its indication for imaging of patients with an allergy to CT's contrast material, and an overall greater sensitivity to hemorrhage, vascular complications, pseudoaneurysms, and venous thrombosis.[4]
- Another advantage of MRI is its utilization of magnetic resonance cholangiopancreatography (MRCP) sequences. MRCP provides useful information regarding the etiology of acute pancreatitis, i.e., the presence of tiny biliary stones (choledocholithiasis or cholelithiasis) and duct anomalies.[3]
- Clinical trials indicate that MRCP can be as effective a diagnostic tool for acute pancreatitis with biliary etiology as endoscopic retrograde cholangiopancreatography, but with the benefits of being less invasive and causing fewer complications.[5][6]
References
- ↑ Stimac D, Miletić D, Radić M; et al. (2007). "The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis". Am. J. Gastroenterol. 102 (5): 997–1004. doi:10.1111/j.1572-0241.2007.01164.x. PMID 17378903.
- ↑ Arvanitakis M, Koustiani G, Gantzarou A, Grollios G, Tsitouridis I, Haritandi-Kouridou A, Dimitriadis A, Arvanitakis C (2007). "Staging of severity and prognosis of acute pancreatitis by computed tomography and magnetic resonance imaging-a comparative study". Dig Liver Dis. 39 (5): 473–482. doi:10.1016/j.dld.2007.01.015. PMID 17363349.
- ↑ 3.0 3.1 Scaglione M, Casciani E, Pinto A, Andreoli C, De Vargas M, Gualdi GF (2008). "Imaging assessment of acute pancreatitis: a review". Semin Ultrasound CT MR. 29 (5): 322–340. doi:10.1053/j.sult.2008.06.009. PMID 18853839.
- ↑ Miller FH, Keppke AL, Dalal K, Ly JN, Kamler VA, Sica GT (2004). "MRI of pancreatitis and its complications: part 1, acute pancreatitis". AJR Am J Roentgenol. 183 (6): 1637–1644. PMID 15547203.
- ↑ Testoni PA, Mariani A, Curioni S, Zanello A, Masci E (2008). "MRCP-secretin test-guided management of idiopathic recurrent pancreatitis: long-term outcomes". Gastrointest Endosc. 67 (7): 1028–1034. doi:10.1016/j.gie.2007.09.007. PMID 18179795.
- ↑ Khalid A, Peterson M, Slivka A (2003). "Secretin-stimulated magnetic resonance pancreaticogram to assess pancreatic duct outflow obstruction in evaluation of idiopathic acute recurrent pancreatitis: a pilot study". Dig Dis Sci. 48 (8): 1475–1481. doi:10.1023/A:1024747319606. PMID 12924639.