Comparative Evaluation of USG, CT, and MRI in Acute Pancreatitis

The present study was conducted to study and associate the findings of imaging - ultrasound (USG), contrast-enhanced computed tomography (CECT), and in some cases, magnetic resonance imaging (MRI), in acute pancreatitis (AP) at our institute.

An observational study was conducted for a duration of 18 months on 70 patients clinically diagnosed with AP. All patients underwent USG and CECT; MRI was performed in three cases.

USG visualized the pancreas in 69 (98.57%) of cases and identified peripancreatic fluid in 56 (80%) and gallstones in 25 (35.71%). However, it failed to see the pancreas in one case due to bowel gases. CT visualized the pancreas in all cases and identified necrosis in 40 (57.14%) cases, peripancreatic fluid in 56 (80%), peripancreatic fat stranding in 53 (75.71%), pseudocysts in four (5.71%), ascites in 36 (51.43%), pleural effusion in 30 (42.86%), and hepatosplenomegaly in 28 (40%), but identified stones in only three (4.28%) cases. Significant association was seen between bulky pancreas on USG and CT (P < 0.0001). MRI/MRCP was conducted in three cases which showed features of AP and confirmed the findings of peripancreatic inflammation, with minimal peripancreatic fluid collection or minimal pleural effusion.

CT was the most reliable modality for assessing disease severity and local complications. USG proved to be a useful initial screening tool, especially for gallstone detection. MRI added value in selected patients.