Abstract
ObjectivesTo study the MRI findings of the pancreatic duct in patients with acute pancreatitis.Materials and MethodsA total of 239 patients with acute pancreatitis and 125 controls were analyzed in this study. The severity of acute pancreatitis was graded using the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation II(APACHE II) scoring systems. The number of main pancreatic duct (MPD) segments visualized, and both MPD diameter and pancreatic duct disruption were noted and compared with the severity of acute pancreatitis.ResultsThe frequency of MPD segment visualization in the control group was higher than that in the acute pancreatitis group (p<0.05). The number of MPD segments visualized was negatively correlated with the MRSI score (p<0.05) and the APACHE II score (p<0.05). There was no difference in the MPD diameter between the acute pancreatitis and control groups or among the patients with different severities of acute pancreatitis (p>0.05). The prevalence of pancreatic duct disruption was 7.9% in the acute pancreatitis group. The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups based on the APACHE II score, respectively, and were 0%, 5.7% and 43.5% in the mild, moderate and severe acute pancreatitis groups according the MRSI score, respectively. The prevalence of pancreatic duct disruption was correlated with the severity of acute pancreatitis based on the APACHE II score (p<0.05) and MRSI score (p<0.05).ConclusionThe pancreatic duct in acute pancreatitis patients was of normal diameter. The number of MPD segments visualized and visible pancreatic duct disruption on MRI may be supplementary indicators for determining the severity of acute pancreatitis.
Highlights
Acute pancreatitis is defined as the acute inammation of the pancreatic gland and the surrounding tissues and is thought to result from the premature activation of pancreatic digestive enzymes [1]
The number of main pancreatic duct (MPD) segments visualized was negatively correlated with the MR severity index (MRSI) score (p,0.05) and the APACHE II score (p,0.05)
The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups based on the APACHE II score, respectively, and were 0%, 5.7% and 43.5% in the mild, moderate and severe acute pancreatitis groups according the MRSI score, respectively
Summary
Acute pancreatitis is defined as the acute inammation of the pancreatic gland and the surrounding tissues and is thought to result from the premature activation of pancreatic digestive enzymes [1]. The majority of patients have mild, self-limiting disease, some develop severe disease involving organ failure. These patients are at risk of developing complications, such as pancreatic necrosis, uid collections, pseudocysts, and pancreatic duct disruption, due to the persistent pancreatic inammation [3]. Pancreatic ductal changes predict spontaneous resolution, the success of nonoperative measures, and the need for direct therapies to treat pseudocysts. Ductal changes can identify patients with necrotizing pancreatitis who are most likely to have immediate and delayed complications [4]
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