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The characteristics of acute necrotizing pancreatitis in different age stages: An MRI study
Dan Dan Yang1, Hou Dong Zuo1, Chang Qiang Wu2
1Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Wenhua Road 63, Nanchong 637099, Sichuan, PR China.
Purpose:
To study the characteristics of acute necrotizing pancreatitis (ANP) in different age stages and their correlations with the clinical outcomes using magnetic resonance imaging (MRI).
Method:
MRI of 716 patients with acute pancreatitis was retrospectively reviewed to assess the incidence and characteristics of ANP. On MRI, ANP was classified into three subtypes: extrapancreatic necrosis (EPN) alone, pancreatic necrosis (PN) alone and combined necrosis. The extent of necrosis was also quantified on MRI. All patients were divided into three age groups, that is, young,middle-aged and elderly groups, and these characteristics of ANP were compared among the three age groups. The endpoints of patients' clinical outcome were compared among different age groups and different characteristics of ANP.
Results:
Of the 716 patients, 129(18 %) were identified as ANP on MRI. The prevalence of ANP in the elderly group was the highest (28.9 %, p < 0.05). The patients in the middle-age and the elderly groups exhibited a higher risk of combined necrosis (56.9 %, 55.8 %; respectively), and elderly patients more frequently had extensive extrapancreatic involvement compared with young patients (65.9 % vs 21.4 %; p = 0.004); however, PN alone was more common in young patients. These characteristics of ANP were significantly bound up with clinical outcomes.
Conclusions:
Different subtypes of ANP have different outcomes. More importantly, age needs to be considered as a factor of special concern in development of ANP.
Insights
Acute necrotizing pancreatitis (ANP) prevalence and characteristics vary by age. Elderly patients show higher ANP rates and more extensive extrapancreatic necrosis, impacting clinical outcomes.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Acute necrotizing pancreatitis (ANP) is a severe form of acute pancreatitis.
- Understanding ANP characteristics across different age groups is crucial for predicting outcomes.
Purpose of the Study:
- To investigate the age-specific characteristics of acute necrotizing pancreatitis (ANP) using magnetic resonance imaging (MRI).
- To correlate ANP subtypes and extent with clinical outcomes in different age demographics.
Main Methods:
- Retrospective review of MRI scans from 716 acute pancreatitis patients.
- Classification of ANP into extrapancreatic necrosis (EPN) alone, pancreatic necrosis (PN) alone, and combined necrosis.
- Quantification of necrosis extent and comparison across young, middle-aged, and elderly groups.
Main Results:
- ANP was identified in 18% of patients, with highest prevalence in the elderly (28.9%).
- Elderly and middle-aged patients had higher rates of combined necrosis.
- Elderly patients showed more extensive extrapancreatic involvement than younger patients.
Conclusions:
- ANP subtypes and their extent significantly correlate with clinical outcomes.
- Age is a critical factor influencing ANP development and presentation.
- Tailoring treatment strategies based on age and ANP characteristics is essential.
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Acute pancreatitis is characterized by rapid inflammation of the pancreas, often caused by factors like gallstone blockage or excessive alcohol consumption. Chronic pancreatitis, on the other hand, is a slow, progressive inflammation that may result from long-term alcohol abuse, obstructions in the pancreatic duct, or genetic factors.
The causes of acute pancreatitis include:

