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Importance of Computed Tomography and Magnetic Resonance Imaging in The Assessment of Acute Pancreatitis

Background and aims: Computed tomography (CT), especially a contrast-enhanced provides important information on the severity and prognosis of acute pancreatitis. Magnetic resonance imaging (MRI) has become a useful tool as an alternative to CT in assessment of acute pancreatitis. The aim of our study was to compare the diagnostic performance of MRI with CT in assessment of acute pancreatitis from third to fifth day after admission. Patients and methods: The study included 79 patients (34 males, 45 females, median age, 62 years ; range 20-83) with diagnosis of acute pancreatitis admitted to our hospital during the period between January 2004 and April 2005. The inclusion criteria consisted of combination of clinical features, a typical case history, elevation of serum pancreatic enzymes and diagnosis confirmed by imaging studies. Contrast-enhanced spiral CT (Shimatzu, Japan) and MRI 0, 5T (Shimatzu, Japan) exams were performed in all patients from third to fifth day after admission and Balthazar grade, extent of peripancreatic necrosis, CTSI (CT Severity index) and MRSI (MR Severity index) were calculated. In correlation assessment we used Spearman rank test. Results: There is a correlation between spiral CT and MRI in evaluation of the inflammation extent, according to Balthazar (r = 0.848) and of severity according to Severity Index - SI (r = 0.617). In eight patients MRI showed hemorrhage that CT didn't reveal. Conclusion: Diagnostic performance of CT and MRI in patients with acute pancreatitis doesn't differ significantly using Balthazar's grade, CTSI and MRSI. MRI is sensitive in diagnosing patients with hemorrhagic necrosis and can give additional information in that group of patients.

computed tomography; magnetic resonance; acute pancreatitis

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