Review
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 14, 2010; 16(22): 2735-2742
Published online Jun 14, 2010. doi: 10.3748/wjg.v16.i22.2735
Magnetic resonance imaging for local complications of acute pancreatitis: A pictorial review
Bo Xiao, Xiao-Ming Zhang, Wei Tang, Nan-Lin Zeng, Zhao-Hua Zhai
Bo Xiao, Xiao-Ming Zhang, Wei Tang, Nan-Lin Zeng, Zhao-Hua Zhai, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong 637000, Sichuan Province, China
Author contributions: Xiao B and Zhang XM contributed equally to this work; Xiao B, Zhang XM, Tang W, Zeng NL and Zhai ZH designed research; Xiao B, Zhang XM and Zeng NL performed research; Xiao B, Tang W and Zhai ZH analyzed the data; Xiao B and Zhang XM wrote the paper.
Supported by Grant No. 206126, Key project of Science and Technology Research, and NCET-06-0820, Ministry of Education, China
Correspondence to: Xiao-Ming Zhang, MD, PhD, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. cjr.zhxm@vip.163.com
Telephone: +86-817-2262218 Fax: +86-817-2222856
Received: February 9, 2010
Revised: March 30, 2010
Accepted: April 6, 2010
Published online: June 14, 2010
Abstract

Acute pancreatitis is a common disease characterized by sudden upper abdominal pain and vomiting. Alcoholism and choledocholithiasis are the most common factors for this disease. The choice of treatment for acute pancreatitis might be affected by local complications, such as local hemorrhage in or around the pancreas, and peripancreatic infection or pseudoaneurysm. Diagnostic imaging modalities for acute pancreatitis have a significant role in confirming the diagnosis of the disease, helping detect the extent of pancreatic necrosis, and for diagnosing local complications. Magnetic resonance imaging (MRI) might be indicated in acute pancreatitis for detecting and characterizing local complications of acute pancreatitis that involve necrotic, hemorrhagic, infectious, vascular, and pseudocyst disorders. The general MRI sequences for pancreatitis require the combined use of T1-weighted, T2-weighted sequences, and magnetic resonance cholangiopancreatography. For imaging of pancreatic necrosis, the combination of T1-weighted and T2-weighted findings with dynamic contrast-enhanced imaging gives a comprehensive evaluation of the extent of necrosis and full range of inflammatory extension. For imaging of infectious complications, dynamic contrast-enhanced examinations might help differentiate pancreatic cellulitis or abscesses, from pancreatic fluid collection or simple pseudocysts. For vascular abnormalities, the combination of cross-sectional pancreatic parenchyma imaging with MRA represents a single diagnostic modality for the full evaluation of peripancreatic artery and vein involvement, such as arterial pseudoaneurysms and venous thromboses. The purpose of this pictorial review is to examine the MRI appearances of various local complications of acute pancreatitis and to discuss the practical setup of MRI in local complications of acute pancreatitis.

Keywords: Pancreas; Pancreatitis; Complication; Magnetic resonance imaging; Pictorial review