Abstract
Purpose
To compare the value of nonenhanced (NE) magnetic resonance imaging (MRI) (NE‐MRI) with contrast‐enhanced (CE) computed tomography (CT) (CE‐CT) scan in assessing acute pancreatitis (AP) and in evaluating the severity index (SI) with clinical outcome.
Materials and Methods
Patients with AP were prospectively investigated by CE‐CT scan and NE‐MRI on admission. MRI was performed with fat‐saturated T1‐weighted imaging, T2‐weighted imaging, and MR cholangiopancreatography (MRCP). Balthazar's grading system was used to evaluate the NE‐MRI severity index (CTSI, MRISI) and it was compared to the clinical outcome.
Results
A total of 90 patients (median age = 55 years) were included in the study. AP was of biliary etiology in 37 patients (41%). On admission, AP was assessed as grade III by CTSI in four patients (4%), whereas 19 patients were classified grade III by MRISI. The coefficient correlation between CTSI and MRISI was good, with r = 0.6 (P < 0.001). Considering CE‐CT scan as the gold standard, sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of NE‐MRI for detecting severe AP based on imaging criteria were 100%, 82.6%, 100%, and 21%, respectively. NE‐MRI discriminates normal pancreatic parenchyma from edema and necrosis with a correlation between morbidity (P < 0.008).
Conclusion
NE‐MRI seems to be a reliable method of staging AP severity in comparison to CE‐CT scan. J. Magn. Reson. Imaging 2007;26:331–338. © 2007 Wiley‐Liss, Inc.