The efficacy of diffusion weighted imaging for detection of acute pancreatitis and comparison of subgroups according to Balthazar classification.

Abstract

The aim of this study was to measure the apparent diffusion coefficient (ADC) values detected by diffusion-weighted imaging (DWI) in acute pancreatitis and compare them with computerized tomography (CT) findings in acute pancreatitis subgrouped by the Balthazar classification. The study population included 50 patients diagnosed with clinical pancreatitis who were evaluated with both multidetector CT and magnetic resonance imaging (MRI) within 24 h of clinical presentation. We calculated pancreatic ADC values obtained from DWI (b=0 and b=1000 mm2/sn). These values were compared with their normal counterparts (n=24). The patients with acute pancreatitis were subgrouped according to the Balthazar classification. The mean ADC values were calculated in each subgroup, and they were compared with control ADC values. The mean pancreatic ADC values in acute pancreatitis (1.19×10(-3) mm2/sn ±0.32) was significantly lower than in the normal group (1.78×10(-3) mm2/sn ±0.29) (p<0.001). In the subgroup analysis, ADC values in each group were significantly lower than in the control group (p<0.001). In addition, as severity of pancreatitis increased according to the Balthazar classification, lower ADC values were noted. DWI with MRI and ADC values are helpful in the diagnosis of all subgroups of acute pancreatitis. Due to the lack of CT findings in grade A patients, DWI may be helpful in the diagnosis in this group as well.