Clinical-liver, pancreas, and biliary tractComputed tomography and magnetic resonance imaging in the assessment of acute pancreatitis
Section snippets
Patients
Patients with AP admitted to our institution during the period between January 2001 and September 2002 were considered for inclusion in this prospective study. Diagnosis of AP was based on the presence of typical abdominal pain combined with a 3-fold elevation of serum levels of amylase and lipase. AP was considered of biliary origin if there was a 2-fold elevation of transaminases combined with the presence of stones in the gallbladder.18 It was considered of alcoholic etiology if it had been
Clinical and laboratory findings
Thirty-nine patients (23 men and 16 women) were included in the study (median age, 47 years; range, 15–86). The median interval between the onset of symptoms and admission was 22 hours (2–48). All patients had a 3-fold elevation of serum amylase and lipase levels. Median serum amylase and lipase values on admission were 643 IU (185–8656) and 1517 IU (141–13,943), respectively (upper normal values were 125 IU and 75 IU for amylase and lipase, respectively). AP was biliary in 19 patients (49%)
Discussion
The present results show that MRI is a reliable alternative to contrast-enhanced CT for assessing the severity of AP and predicting its outcome. MRI indeed allowed evaluation of the spread of pancreatic and extrapancreatic acute fluid collections, as well as the extent of necrosis. The major advantages of MRI are that it can be proposed to nearly all patients without clinical limitations and its accurate visualization of pancreatic and biliary ducts permits the detection of pancreatic duct
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