Abbreviated non-enhanced magnetic resonance imaging in patients with acute necrotizing pancreatitis
Akash Bansal1, Rajath Ramegowda1, Pankaj Gupta2
1Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Aim:
To investigate the performance of T2-weighted abbreviated magnetic resonance imaging (T2W-AMRI) protocol in evaluating patients with acute necrotizing pancreatitis (ANP).
Methods:
A retrospective analysis of consecutive hospitalized patients with ANP who underwent MRI (contrast-enhanced, CE or non-contrast, NC) between January 2017 and November 2020 was performed. The T2W-AMRI and complete MRI (cMRI) sequences were anonymized, and subsequently, two separate sets of data (AMRI and cMRI) were created for presentation to the radiologists involved in reading the data. The T2W-AMRI was based on a single-axial T2 half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequence. The pancreatic and extrapancreatic findings were recorded and tabulated independently by two radiologists on T2W-AMRI and cMRI. In addition, the interobserver agreement and association of findings between T2W-AMRI and cMRI were analyzed.
Results:
Twenty-eight patients (mean age 31.7 ± 12.2 years, 17 females) were included. Thirteen patients had CE-cMRI, while the rest underwent NC-cMRI. There was no significant difference in the identification of pancreatic necrosis on T2W-AMRI vs. cMRI (p = 1.00). However, T2W-AMRI underestimated necrosis in one patient. Collections were accurately detected in all patients on T2W-AMRI. The mean size of the collection was larger on cMRI (6.5 ± 3.7 cm) than T2W-AMRI (6 ± 3.7 cm) with p = 0.006. cMRI detected more patients with disrupted pancreatic duct (n = 9) than T2W-AMRI (n = 6). However, the difference was not statistically significant (p = 0.375). There was a good to an excellent interobserver agreement between the readers for T2W-AMRI (k = 0.62-1).
Conclusion:
T2W-AMRI may offer a suitable alternative to cMRI in ANP, especially severe disease, as it can be acquired rapidly without the need for contrast injection.
Insights
T2-weighted abbreviated MRI (T2W-AMRI) shows promise for evaluating acute necrotizing pancreatitis (ANP). This rapid, non-contrast imaging technique offers comparable diagnostic performance to complete MRI, especially for severe cases.
Area of Science:
- Radiology
- Medical Imaging
- Gastroenterology
Background:
- Acute necrotizing pancreatitis (ANP) requires accurate and timely evaluation.
- Complete MRI (cMRI) is effective but can be time-consuming and require contrast agents.
- Abbreviated MRI protocols may offer a faster alternative.
Purpose of the Study:
- To assess the diagnostic performance of T2-weighted abbreviated MRI (T2W-AMRI) for ANP.
- To compare T2W-AMRI findings with complete MRI (cMRI).
- To evaluate interobserver agreement for T2W-AMRI.
Main Methods:
- Retrospective analysis of 28 ANP patients who underwent MRI.
- Comparison of T2W-AMRI (single axial T2 HASTE sequence) with cMRI (contrast-enhanced or non-contrast).
- Independent assessment by two radiologists, analyzing pancreatic and extrapancreatic findings, and interobserver agreement.
Main Results:
- No significant difference in identifying pancreatic necrosis between T2W-AMRI and cMRI (p=1.00).
- Collections were accurately detected by T2W-AMRI; mean collection size was slightly smaller than with cMRI (p=0.006).
- Good to excellent interobserver agreement (k=0.62-1) for T2W-AMRI findings.
Conclusions:
- T2W-AMRI demonstrates comparable performance to cMRI in evaluating ANP.
- T2W-AMRI is a potentially suitable, rapid, non-contrast alternative for ANP assessment, particularly in severe cases.
More Related Videos
06:24Dynamic Contrast Enhanced Magnetic Resonance Imaging of an Orthotopic Pancreatic Cancer Mouse Model
Published on: April 18, 2015
07:38Preparing a Mice Model of Severe Acute Pancreatitis via a Combination of Caerulein and Lipopolysaccharide Intraperitoneal Injection
Published on: May 10, 2024
Related Concept Videos
01:30Acute Pancreatitis II: Clinical Manifestations and Management
01:24Magnetic Resonance Imaging
01:27Acute Pancreatitis I: Introduction
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:
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...
01:29Chronic Pancreatitis II: Collaborative Care
Assessment: