The Role of Nonenhanced Magnetic Resonance Imaging in the Early Assessment of Acute Pancreatitis

Štimac, Davor; Miletić, Damir; Radić, Mladen; Krznaric, I.; Mazur-Grbac, Marzena; Perković, Domagoj; Milić, Sandra; Golubović, Vesna

doi:10.1111/j.1572-0241.2007.01164.x

Cited by 101 publications

(63 citation statements)

References 23 publications

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“…MRI for acute pancreatitis clinical outcome [12,25] . Moreover, there is an additional and inevitable problem that infection cannot be excluded in areas of gland necrosis (mentioned below).…”

Section: Pancreatic Necrosismentioning

confidence: 99%

“…Advantages for using MRI in patients with acute pancreatitis are as follows: (1) it is a diagnostic imaging method without radiation hazard; (2) it is particularly useful in patients who cannot receive iodinated contrast material owing to allergic reactions or other contraindications; (3) MRCP has the unique capability of providing noninvasive images of pancreatic parenchyma and pancreatic duct integrity, and it has the advantage of demonstrating possible communication of a pancreatic pseudocyst with pancreatic ducts [8,15] ; (4) MRI has a potential advantage over CT in detecting bile duct lithiasis and pancreatic hemorrhage of pseudocysts or pseudoaneurysm, which can help plan surgery; (5) nonenhanced MRI seems to be more accurate and reliable for the early assessment of severity and prognosis of acute pancreatitis than is contrast-enhanced CT [12,16,17] ; and (6) non-enhanced MRI is superior to CT for depiction and confirmation of mild forms of acute pancreatitis [18] . Nevertheless, there are several limitations for using MRI in this disease.…”

Section: Introductionmentioning

confidence: 99%

“…However, visualization of the pancreas is often disturbed by overlying gastrointestinal gas, which is an important limitation for US applications in this disease [8] . Contrast-enhanced computerized tomography (CT) is often used to aid the diagnosis of pancreatic necrosis and help evaluate the presence and development of local complications in acute pancreatitis [12] . CT severity index (CTSI), a very good imaging grading system for disease severity, has shown excellent correlation with the incidence of death in patients with acute pancreatitis [4,8] .…”

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging for acute pancreatitis

Xiao¹

2010

WJR

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Acute pancreatitis is characterized by acute chemical injury of the pancreatic parenchyma and peripancreatic tissue. The increased frequency of death in acute pancreatitis is directly correlated with the degree and progress of pancreatic necrosis. Moreover, the occurrence of some local complications in acute pancreatitis, such as pancreatic hemorrhage, peripancreatic abscess or large pseudocyst, and pseudoaneurysm, could influence the choice of treatment for these patients. Magnetic resonance imaging (MRI) can be used to help evaluate the presence and degree of pancreatic necrosis, and is crucial for identifying complications of acute pancreatitis and predicting prognosis. The purpose of this article is to describe MRI techniques for acute pancreatitis, to review the spectrum of pancreatic and peripancreatic patterns, as well as to survey various complications secondary to acute pancreatitis on MRI. The role of MRI in the initial evaluation and staging of acute pancreatitis is emphasized.

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Section: Pancreatic Necrosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Magnetic resonance imaging for acute pancreatitis

Xiao¹

2010

WJR

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“…[12] Modified Atlanta classification is a relatively objective index to evaluate both local and systemic changes in the development and progression of the disease. [13] There are multiple scoring systems available to assess the severity of acute pancreatitis. Ranson and APACHE II scores are usually used to assess the severity of acute pancreatitis in most institutions.…”

Section: Discussionmentioning

confidence: 99%

Bisap Score: A Simple Tool to Assess the Severity and Predict the Morbidity and Mortality in Acute Pancreatitis

Hariprasad¹,

Haridarshan²,

Puneetha³

et al. 2015

jemds

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NEED FOR STUDYThe present study is to use a simple bedside tool as a scoring system to assess the severity of acute pancreatitis and to predict its risks for morbidity and mortality. The main criteria of this study is to highlight the ease of using this tool to identify the severity of acute pancreatitis as early as possible in order to reduce the complications, risks and to improve the outcome and overall survival. MATERIALS AND METHODSOur study is a single centre, prospective observational study conducted at Rajarajeshwari Medical College Hospital, Bangalore, India from September 2014 to September 2015. Forty six patients, both males and females presenting within 24 hours of onset of symptoms diagnosed with acute pancreatitis were included in the study. Informed consents were obtained from all patients. Cases of chronic pancreatitis and acute on chronic pancreatitis were excluded. Pediatric patients of age less than 14 years and geriatric patients more than 70 years were excluded. RESULTSWe observed that biliary pancreatitis was the most common with male population more affected than females. Pain abdomen was the most common presentation in the entire study population. Necrotizing pancreatitis was most commonly associated with ICU admission and prolonged hospital stay. Patients with organ failure and BISAP score more than 3 were found to have prolonged hospital stay. SIRS was the most common component of BISAP scoring system seen in 91.3%. Elderly patients with age more than 60 years (6 pts.) had high BISAP score (5). All patients with shock had BISAP score of >3. A BISAP score of ≥3 was associated with higher morbidity than scores of <3. CONCLUSIONBISAP is a simple and a quick tool over other scoring systems and is similar to other scoring systems to predict the severity and prognosis of acute pancreatitis. In summary we have studied the ease of BISAP scoring system and its advantage in early recognition of acute pancreatitis, thus taking early steps to provide specific treatment to prevent complications, reduce the risks and to improve the overall survival.

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“…Due to the composition of soft tissue, MRI can produce morphologic images with a very high resolution in AP. [22][23][24] The imaging agent we aim to use is gadolinium-diethylenetriaminepentaacetic (Gd-DTPA), a beneficial positive contrast agent with a long history of use in MRI examination of AP. 25,26 Liposomes are promising nanomedicines for targeted drug delivery and imaging.…”

Section: Introductionmentioning

confidence: 99%

Mannose-coated gadolinium liposomes for improved magnetic resonance imaging in acute pancreatitis

Tian¹,

Liu²,

Chen³

et al. 2017

IJN

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Background Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas. The symptoms, treatment, and prognosis of mild and severe AP are different, and severe AP is a potentially life-threatening disease with a high incidence of complications and high mortality rate. Thus, it is urgent to develop an effective approach to reliably discriminate between mild and severe AP. Methods We have developed novel gadolinium-diethylenetriaminepentaacetic (Gd-DTPA)-loaded mannosylated liposomes (named thereafter M-Gd-NL) that preferably target macrophages in AP. The targeting ability of M-Gd-NL toward macrophages in AP and its ability to discriminate between mild and severe AP were evaluated. Results The liposomes were of desired particle size (~100 nm), Gd-DTPA encapsulation efficiency (~85%), and stability. M-Gd-NL and non-targeted Gd-DTPA-loaded liposomes (Gd-NL) exhibited increased relaxivity compared with Gd-DTPA. Compared with Gd-NL and Gd-DTPA, M-Gd-NL showed increased uptake in macrophages, resulting in increased T 1 imaging ability both in vitro (macrophage cell line) and in vivo (severe AP model). Importantly, M-Gd-NL had the ability to discriminate between mild and severe AP, as reflected by a significantly higher T 1 magnetic resonance imaging signal in severe AP than in mild AP. M-Gd-NL did not show severe organ toxicity in rats. Conclusion Our data suggest that M-Gd-NL had enhanced magnetic resonance imaging ability by targeting macrophages in AP and good ability to discriminate between mild and severe AP. We believe that M-Gd-NL could shed new light on the diagnosis of AP in the near future.

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The Role of Nonenhanced Magnetic Resonance Imaging in the Early Assessment of Acute Pancreatitis

Abstract: NEMRI is comparable to CECT in the early assessment of the severity of AP, and both methods are equally efficient in predicting local and systemic complications of AP. MRI has a potential advantage over CT in detecting bile duct lithiasis and pancreatic hemorrhage.

Cited by 101 publications

References 23 publications

Magnetic resonance imaging for acute pancreatitis

Magnetic resonance imaging for acute pancreatitis

Bisap Score: A Simple Tool to Assess the Severity and Predict the Morbidity and Mortality in Acute Pancreatitis

Mannose-coated gadolinium liposomes for improved magnetic resonance imaging in acute pancreatitis

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