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Pancreatic duct patterns in acute pancreatitis: a MRI study.

Peng R, Zhang XM, Ji YF, Chen TW, Yang L, Huang XH, Chi XX - PLoS ONE (2013)

Bottom Line: The number of main pancreatic duct (MPD) segments visualized, and both MPD diameter and pancreatic duct disruption were noted and compared with the severity of acute pancreatitis.The pancreatic duct in acute pancreatitis patients was of normal diameter.The number of MPD segments visualized and visible pancreatic duct disruption on MRI may be supplementary indicators for determining the severity of acute pancreatitis.

View Article: PubMed Central - PubMed

Affiliation: Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, the People's Republic of China.

ABSTRACT

Objectives: To study the MRI findings of the pancreatic duct in patients with acute pancreatitis.

Materials and methods: A total of 239 patients with acute pancreatitis and 125 controls were analyzed in this study. The severity of acute pancreatitis was graded using the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation II(APACHE II) scoring systems. The number of main pancreatic duct (MPD) segments visualized, and both MPD diameter and pancreatic duct disruption were noted and compared with the severity of acute pancreatitis.

Results: The frequency of MPD segment visualization in the control group was higher than that in the acute pancreatitis group (p<0.05). The number of MPD segments visualized was negatively correlated with the MRSI score (p<0.05) and the APACHE II score (p<0.05). There was no difference in the MPD diameter between the acute pancreatitis and control groups or among the patients with different severities of acute pancreatitis (p>0.05). The prevalence of pancreatic duct disruption was 7.9% in the acute pancreatitis group. The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups based on the APACHE II score, respectively, and were 0%, 5.7% and 43.5% in the mild, moderate and severe acute pancreatitis groups according the MRSI score, respectively. The prevalence of pancreatic duct disruption was correlated with the severity of acute pancreatitis based on the APACHE II score (p<0.05) and MRSI score (p<0.05).

Conclusion: The pancreatic duct in acute pancreatitis patients was of normal diameter. The number of MPD segments visualized and visible pancreatic duct disruption on MRI may be supplementary indicators for determining the severity of acute pancreatitis.

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Related in: MedlinePlus

Pancreatic duct disruption in a 44-year-old female with acute pancreatitis.The Acute Physiology And Chronic Healthy Evaluation II score was 15, and the magnetic resonance severity index was 10. (A), (B) Coronal single-shot fast spin-echo T2-weighted images and (C) magnetic resonance cholangiopancreatography show a complex 8.5-cm-diameter fluid collection (long arrow) in the head, body and proximal tail of the pancreas. The main pancreatic duct (short arrow) enters the fluid collection at an angle of approximately 90°.
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pone-0072792-g004: Pancreatic duct disruption in a 44-year-old female with acute pancreatitis.The Acute Physiology And Chronic Healthy Evaluation II score was 15, and the magnetic resonance severity index was 10. (A), (B) Coronal single-shot fast spin-echo T2-weighted images and (C) magnetic resonance cholangiopancreatography show a complex 8.5-cm-diameter fluid collection (long arrow) in the head, body and proximal tail of the pancreas. The main pancreatic duct (short arrow) enters the fluid collection at an angle of approximately 90°.

Mentions: Pancreatic duct disruption was observed in 19 patients (7.9%) (Figure 3 and Figure 4). The prevalences of pancreatic duct disruption were 0%, 5.7% and 43.5% for the mild, moderate and severe acute pancreatitis groups according to the MRSI (p<0.05 between the severe group and the non-severe group) (Table 6). The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups according to the APACHE II score (p<0.05) (Table 7). The frequency of pancreatic duct disruption in patients with acute pancreatitis increased with increasing APACHE II and MRSI scores. The prevalence of pancreatic duct disruption was correlated with the acute pancreatitis severity determined by the MRSI (non-severe vs. severe group, Spearman’s rank correlation coefficient, r = 0.429, p<0.001) and the APACHE II score (Spearman’s rank correlation coefficient, r = 0.178, p = 0.003).


Pancreatic duct patterns in acute pancreatitis: a MRI study.

Peng R, Zhang XM, Ji YF, Chen TW, Yang L, Huang XH, Chi XX - PLoS ONE (2013)

Pancreatic duct disruption in a 44-year-old female with acute pancreatitis.The Acute Physiology And Chronic Healthy Evaluation II score was 15, and the magnetic resonance severity index was 10. (A), (B) Coronal single-shot fast spin-echo T2-weighted images and (C) magnetic resonance cholangiopancreatography show a complex 8.5-cm-diameter fluid collection (long arrow) in the head, body and proximal tail of the pancreas. The main pancreatic duct (short arrow) enters the fluid collection at an angle of approximately 90°.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3755985&req=5

pone-0072792-g004: Pancreatic duct disruption in a 44-year-old female with acute pancreatitis.The Acute Physiology And Chronic Healthy Evaluation II score was 15, and the magnetic resonance severity index was 10. (A), (B) Coronal single-shot fast spin-echo T2-weighted images and (C) magnetic resonance cholangiopancreatography show a complex 8.5-cm-diameter fluid collection (long arrow) in the head, body and proximal tail of the pancreas. The main pancreatic duct (short arrow) enters the fluid collection at an angle of approximately 90°.
Mentions: Pancreatic duct disruption was observed in 19 patients (7.9%) (Figure 3 and Figure 4). The prevalences of pancreatic duct disruption were 0%, 5.7% and 43.5% for the mild, moderate and severe acute pancreatitis groups according to the MRSI (p<0.05 between the severe group and the non-severe group) (Table 6). The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups according to the APACHE II score (p<0.05) (Table 7). The frequency of pancreatic duct disruption in patients with acute pancreatitis increased with increasing APACHE II and MRSI scores. The prevalence of pancreatic duct disruption was correlated with the acute pancreatitis severity determined by the MRSI (non-severe vs. severe group, Spearman’s rank correlation coefficient, r = 0.429, p<0.001) and the APACHE II score (Spearman’s rank correlation coefficient, r = 0.178, p = 0.003).

Bottom Line: The number of main pancreatic duct (MPD) segments visualized, and both MPD diameter and pancreatic duct disruption were noted and compared with the severity of acute pancreatitis.The pancreatic duct in acute pancreatitis patients was of normal diameter.The number of MPD segments visualized and visible pancreatic duct disruption on MRI may be supplementary indicators for determining the severity of acute pancreatitis.

View Article: PubMed Central - PubMed

Affiliation: Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, the People's Republic of China.

ABSTRACT

Objectives: To study the MRI findings of the pancreatic duct in patients with acute pancreatitis.

Materials and methods: A total of 239 patients with acute pancreatitis and 125 controls were analyzed in this study. The severity of acute pancreatitis was graded using the MR severity index (MRSI) and the Acute Physiology And Chronic Healthy Evaluation II(APACHE II) scoring systems. The number of main pancreatic duct (MPD) segments visualized, and both MPD diameter and pancreatic duct disruption were noted and compared with the severity of acute pancreatitis.

Results: The frequency of MPD segment visualization in the control group was higher than that in the acute pancreatitis group (p<0.05). The number of MPD segments visualized was negatively correlated with the MRSI score (p<0.05) and the APACHE II score (p<0.05). There was no difference in the MPD diameter between the acute pancreatitis and control groups or among the patients with different severities of acute pancreatitis (p>0.05). The prevalence of pancreatic duct disruption was 7.9% in the acute pancreatitis group. The prevalences of pancreatic duct disruption were 4.8% and 15.3% in the mild and severe acute pancreatitis groups based on the APACHE II score, respectively, and were 0%, 5.7% and 43.5% in the mild, moderate and severe acute pancreatitis groups according the MRSI score, respectively. The prevalence of pancreatic duct disruption was correlated with the severity of acute pancreatitis based on the APACHE II score (p<0.05) and MRSI score (p<0.05).

Conclusion: The pancreatic duct in acute pancreatitis patients was of normal diameter. The number of MPD segments visualized and visible pancreatic duct disruption on MRI may be supplementary indicators for determining the severity of acute pancreatitis.

Show MeSH
Related in: MedlinePlus