Back to Search
Start Over
Early diagnosis and severity assessment of acute pancreatitis (AP) using MR elastography (MRE) with spin-echo echo-planar imaging.
- Source :
-
Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2017 Nov; Vol. 46 (5), pp. 1311-1319. Date of Electronic Publication: 2017 Mar 02. - Publication Year :
- 2017
-
Abstract
- Purpose: To evaluate the accuracy of magnetic resonance elastography (MRE) in comparison to contrast-enhanced computed tomography (CE-CT) for early diagnosis and prediction of severity in acute pancreatitis (AP).<br />Materials and Methods: This cross-sectional prospective study included 76 patients with suspected AP who underwent both CE-CT and 3.0T MRE within 24 hours of hospital admission. Pancreatic stiffness, CT severity index (CTSI), Acute Physiology and Chronic Health Evaluation (APACHE)-II, and Bedside Index for Severity in AP (BISAP) scores were comparatively evaluated using data from the first 24 hours of admission, and diagnosis and severity of AP were confirmed according to the revised Atlanta Classification (2012). The accuracy of MRE for predicting disease severity was compared with that of CE-CT and the clinical scoring systems using area under the receiver-operating curve (AUC) analysis.<br />Results: AP was confirmed in 56/76 patients (73.7%). Pancreatic stiffness values of >1.47 kPa showed significantly better diagnostic performance than CE-CT (AUC: 0.993 vs. 0.818, P < 0.001) along with greater sensitivity (96.4% vs. 78.6%, P = 0.006) and accuracy (96.1% vs. 81.6%, P = 0.007). Ten patients (10/76; 13.2%) had clinically severe AP. The accuracy of pancreatic stiffness >2.47 kPa was comparable to that of the CTSI, APACHE-II and BISAP scores for predicting severe AP (accuracy = 85.5%, 75.0%, 88.2%, and 78.9%, respectively). The pairwise comparisons were not significant after Bonferroni correction (P < 0.008 [0.05/6]), with P values of 0.008 (MRE vs. CTSI), 0.823 (MRE vs. APACHE-II) and 0.414 (MRE vs. BISAP).<br />Conclusion: Early MRE is a useful, noninvasive method for both diagnosis and early severity assessment of AP. We recommend MRE at hospital admission for initial evaluation of AP.<br />Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1311-1319.<br /> (© 2017 International Society for Magnetic Resonance in Medicine.)
- Subjects :
- APACHE
Abdominal Pain
Acute Disease
Body Mass Index
Cross-Sectional Studies
Elasticity Imaging Techniques
Female
Healthy Volunteers
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Pancreatitis physiopathology
Patient Admission
Predictive Value of Tests
Pressure
Prospective Studies
Reproducibility of Results
Software
Contrast Media chemistry
Echo-Planar Imaging
Pancreatitis diagnostic imaging
Severity of Illness Index
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1522-2586
- Volume :
- 46
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of magnetic resonance imaging : JMRI
- Publication Type :
- Academic Journal
- Accession number :
- 28252868
- Full Text :
- https://doi.org/10.1002/jmri.25679