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Dynamic Contrast-Enhanced MRI for Measuring Pancreatic Perfusion in Acute Pancreatitis: A Preliminary Study
Ran Hu1, Hua Yang1, Yong Chen2
1Chongqing Traditional Chinese Medicine Hospital, Department of Radiology, No.6, Panxi 7th Road, Jiangbei District, Chongqing 400021, China.
Rationale And Objectives:
To assess the characteristics of pancreatic perfusion in normal pancreas and acute pancreatitis (AP) by using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI).
Method And Materials:
Eighty-One AP patients and 26 normal subjects underwent DCE-MRI. The Omitk-Tool was used to analyze perfusion parameters such as Ktrans, Vp, and AUC. The parameters of pancreas between AP and control groups were compared. In AP patients, the parameters were compared between edematous and necrotizing pancreatitis and among different grades of AP as determined by MR severity index (MRSI) and the 2012 Revised Atlanta Classification of AP.
Results:
The Ktrans, Vp, and AUC values of AP were lower than those of the control group (p = 0.007, 0.000, and 0.025). According to MRSI, the Ktrans and AUC values were significantly different between mild and moderate (p = 0.000, 0.000) and between mild and severe (p = 0.008, 0.016) AP but not between moderate and severe AP (p = 0.218, 0.217). Based on the 2012 Revised Atlanta Classification, the Ktrans values were significantly different between mild and moderately severe (p = 0.000) and between mild and severe (p = 0.005) AP, but not between moderately severe and severe AP (p = 0.619). The Ktrans values were significantly different between edematous and necrotizing pancreatitis (p = 0.03).
Conclusion:
The application of DCE-MRI to evaluate pancreatic perfusion contributes to the diagnosis of AP and its severity grade. Pancreatic perfusion is lower in AP patients than in patients with a normal pancreas, and pancreatic perfusion tends to decrease as the severity of AP increases.
Insights
Dynamic contrast-enhanced MRI reveals reduced pancreatic perfusion in acute pancreatitis (AP). Perfusion parameters like Ktrans decrease with increasing AP severity, aiding diagnosis and grading.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute pancreatitis (AP) is a significant gastrointestinal condition.
- Accurate assessment of pancreatic perfusion is crucial for diagnosing and grading AP.
- Dynamic contrast-enhanced MRI (DCE-MRI) offers advanced imaging capabilities.
Purpose of the Study:
- To evaluate pancreatic perfusion characteristics in normal subjects and AP patients using DCE-MRI.
- To correlate perfusion parameters with AP severity and classification.
Main Methods:
- Eighty-one AP patients and 26 controls underwent DCE-MRI.
- Perfusion parameters (Ktrans, Vp, AUC) were analyzed using the Omitk-Tool.
- Comparison of parameters between AP and control groups, and within AP subgroups based on MRSI and Atlanta Classification.
Main Results:
- AP patients exhibited significantly lower Ktrans, Vp, and AUC values compared to controls.
- Ktrans and AUC values differed significantly across AP severity grades (mild, moderate, severe) by MRSI.
- Ktrans values showed significant differences between mild, moderately severe, and severe AP based on the 2012 Atlanta Classification, and between edematous and necrotizing pancreatitis.
Conclusions:
- DCE-MRI is a valuable tool for assessing pancreatic perfusion in AP.
- Reduced pancreatic perfusion is characteristic of AP and correlates with disease severity.
- DCE-MRI aids in the diagnosis and grading of acute pancreatitis.
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