Share：
Share this content in WeChat
X
[Chinese][PDF]99587
• Clinical Article •
Peripancreatic vascular involvement in acute pancreatitis: a MRI study
ZHAO Qiang  ZHANG Xiao-ming 

DOI:10.12015/issn.1674-8034.2016.02.007.


[Abstract] Objective: To study MRI findings of peripancreatic vascular involvement in acute pancreatitis(AP) as well as correlations between vascular involvement and the severity of acute pancreatitis according to the magnetic resonance severity index(MRSI).Materials and Methods: A total of 326 patients with AP admitted to our institution from August 2009 to August 2013 were included in this study. All cases signed informed consent. MRI plain scan and enhanced scan were performed within 72 hours after admission. MRI findings of acute pancreatitis were noted. The peripancreatic vascular involvement was noted in AP on MRI. Spearman correlation of peripancreatic vascular involvement with the MRSI scores were analyzed.Results: At mild, moderate and severe AP according to MRSI, the prevalence of peripancreatic vascular involvement were 3%(4/124), 17%(31/180), 91%(20/22) respectively in 326 patients. The prevalence among splenic vein thrombosis(7 patients), superior mesenteric vein thrombosis(5 patients), splenic vein invasion(49 patients), splenic artery invasion(47 patients) at mild, moderate and severe AP according to MRSI had statistics differences and was positively correlated with the MRSI score (P<0.05, 0.3<r<0.5). The prevalence among celiac trunk invasion (21 patients), portal vein invasion (41 patients), common hepatic artery invasion (39 patients), superior mesenteric artery invasion (36 patients), superior mesenteric vein invasion (24 patients) at mild, moderate and severe AP according to MRSI had statistics differences and was not positively correlated with the MRSI score (P<0.05, r<0.3). The prevalence among portal vein thrombosis (4 patients), splenic artery pseudoaneurysm (3 patients) at mild, moderate and severe AP according to MRSI had not statistics differences and was not positively correlated with the MRSI score (P>0.05, r<0.3).Conclusions: Some patients with AP show peripancreatic vascular involvement on MRI. The prevalence of splenic vein thrombosis, superior mesenteric vein thrombosis, splenic vein invasion and splenic artery invasion has a positive correlation with the severity of AP on MRI.
[Keywords] Acute pancreatitis；Magnetic resonance imaging；Peripancreatic vascular involvement；MR severity index

ZHAO Qiang Department of Radiology, First people’s Hospital of Chong Qing New North Zone, Chongqing 401121, China

ZHANG Xiao-ming* Department of Radioloy, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

*Correspondence to: Zhang XM, E-mail: cjr.zhxm@vip.163.com

Conflicts of interest   None.

Received  2015-12-07
Accepted  2015-12-30
DOI: 10.12015/issn.1674-8034.2016.02.007
DOI:10.12015/issn.1674-8034.2016.02.007.

[1]
Bruennler T, Langgartner J, Lang S, et al. Outcome of patients with acute, necrotizing pancreatitis requiring drainage-does drainage size matter. World J Gastroenterol, 2008, 14(5): 725.
[2]
Luo Y, Yuan CX, Peng YL, et al. Can ultrasound predict the severity of acute pancreatitis early by observing acute fluid collection. World J Gastroenterol, 2001, 7(2): 293-295.
[3]
Zerem E, Imamović G, Sušić A, et al. Step-up approach to infected necrotising pancreatitis: a 20-year experience of percutaneous drainage in a single centre. Dig Liver Dis, 2011, 43(6): 478-483.
[4]
Mortelé KJ, Mergo PJ, Taylor HM, et al. Peripancreatic vascular abnormalities complicating acute pancreatitis:contrast-enhanced helical CT findings. Eur J Radiol, 2004, 52(1): 67-72.
[5]
van Santvoort HC, Besselink MG, Bakker OJ, et al. A step-up approach or open necrosectomy for necrotizing pancreatitis. N Engl J Med, 2010, 362(16): 1491-1502.
[6]
van Santvoort HC, Bakker OJ, Bollen TL, et al. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology, 2011, 141(4): 1254-1263.
[7]
Balthazar EJ, Megibow AJ, Robinson DL, et al. Acute pancreatitis: value of CT in establishing prognosis. Radiology, 1990, 174(2): 331-336.
[8]
Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology, 2002, 223(3): 603-613.
[9]
Balthazar EJ, vanSonnenberg E, Freeny PC. Imaging and intervention in acute pancreatitis. Radiology, 1994, 193(2): 297-306.
[10]
Urban BA, Curry CA, Fishman EK. Complications of acute pancreatitis: helical CT evaluation. Emerg Radiol, 1999, 6(2): 113-120.
[11]
Viremouneix L, Gautier G, Monneuse O, et al. Prospective evaluation of nonenhanced MR imaging in acute pancreatitis. J Magn reson imaging, 2007, 26(2): 331-338.
[12]
Arvanitakis M, Gantzarou A, Koustiani G, et al. Staging of severity and prognosis of acute pancreatitis by computed tomography and magnetic resonance imaging-a comparative study. Dig Liver Dis, 2007, 39(5): 473-482.
[13]
Kim YK, Han YM, Kim CS. Role of fat-suppressed t1-weighted magnetic resonance imaging in predicting severity and prognosis of acute pancreatitis: an intraindividual comparison with multidetector computed tomography. J Comput assist tomogr, 2009, 33(5): 651-656.
[14]
潘华山, 张小明. 急性胰腺炎的MRI评价. 国际医学放射学杂志, 2010, 33(1): 34-37.
[15]
赵强, 张小明, 曾南林. 3.0 T MRI对正常胰腺直接供血动脉的显示. 磁共振成像, 2013, 4(6): 401-404.
[16]
Banks PA, Dervenis C, Bollen TL, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut, 2013, 62(1): 102-111.
[17]
肖波, 蒋志琼, 张小明. 急性胰腺炎的并发症:胰周血管疾病的MRI表现. 临床放射学杂志, 2011, 30(11): 1625-1628.
[18]
Bergert H, Hinterseher I, Kersting S, et al. Management and outcome of hemorrhage due to arterial pseudoaneurysms in pancreatitis. Surgery, 2005, 137(3): 323-328.
[19]
Dörffel T, Wruck T, Rückert RI, et al. Vascular complications in acute pancreatitis assessed by color duplex ultrasonography. Pancreas, 2000, 21(2): 126-133.
[20]
Kirby JM, Vora P. Vascular complications of pancreatitis: imaging and intervention. Cardiovasc Intervent Radiol, 2008, 31(5): 957-970.
[21]
Suzuki T, Ishida H, Komatsuda T, et al. Pseudoaneurysm of the gas-troduodenal artery ruptured into the superior mesenteric vein in a patient with chronic pancreatitis. J Clin Ultrasound, 2003, 31(5): 278-282.
[22]
Rebours V, Boudaoud L, Vullierme MP, et al. Extrahepatic portal venous system thrombosis in recurrent acute and chronic alcoholic pancreatitis is caused by local inflammation and not thrombophilia. Am J Gastroenterol, 2012, 107(10): 1579-1585.
[23]
Harris S, Nadkarni, Naina HV, et al. Splanchnic vein thrombosis in acute pancreatitis: a single-center experience. Pancreas, 2013, 42(8): 1251-1254.
[24]
Bernades P, Baetz A, Levy P, et al. Splenic and portal venous obstruction in chronic pancreatitis. A prospective longitudinal study of a medical surgical series of 266 patients. Dig Dis Sci, 1992, 37(3): 340-346.

PREV Follow-up value of Multi-modality imaging in the MRI assessment of recurrence after transcatheter arterial chemo embolization combined radiofrequency ablation of nodular hepatocellular carcinoma
NEXT Value of STIR sequence in diagnosis of lumbosacral superficial fasciitis
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn