Chao-Lian Xie1, Mao Zhang2, Yong Chen1, Ran Hu1, Meng-Yue Tang1, Tian-Wu Chen1, Hua-Dan Xue3, Zheng-Yu Jin3, Xiao-Ming Zhang1. 1. Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China. 2. Department of General Surgery, the Fourth People's Hospital of Sichuan Province, Chengdu 610021, China. 3. Radiology Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100000, China.
Abstract
BACKGROUND: To investigate the spleen and splenic vascular involvement in acute pancreatitis (AP) and their correlations with the severity of AP using magnetic resonance imaging (MRI). METHODS: MRI of 239 patients with AP was retrospectively reviewed to assess splenic and splenic vascular complications, and the severity of AP. The severity of AP was graded by the MRI severity index (MRSI) and the New Revised Classification of AP 2012. The intravoxel incoherent motion (IVIM) parameters (D, D*, and f) of spleen were measured. Thirty-five subjects without pancreatic and splenic disorders were enrolled as controls for IVIM parameters. RESULTS: Among the 239 patients with AP, splenomegaly (16.7%), splenic infarction (0.4%), splenic vein thrombosis (4.2%), phlebitis (7.5%) and arteritis (4.2%) were observed. Splenic vascular involvement was positively correlated with the severity of AP based on both the MRSI and the New Revised Classification of AP 2012 (P<0.05). In the control and AP groups, the splenic f values were (0.164±0.074) vs. (0.210±0.095) (P=0.023) respectively. In AP patients with and without splenomegaly, f = (0.240±0.091) vs. (0.203±0.095) (P<0.001). CONCLUSIONS: Splenic vascular involvement and splenomegaly were common in AP. The vascular involvement was associated with the severity of AP. This complication should be considered when severity and prognosis of AP are assessed. Quantitative analysis of the spleen with IVIM might be a useful imaging biomarker for splenic perfusion changes in AP, especially in those with splenomegaly.
BACKGROUND: To investigate the spleen and splenic vascular involvement in acute pancreatitis (AP) and their correlations with the severity of AP using magnetic resonance imaging (MRI). METHODS: MRI of 239 patients with AP was retrospectively reviewed to assess splenic and splenic vascular complications, and the severity of AP. The severity of AP was graded by the MRI severity index (MRSI) and the New Revised Classification of AP 2012. The intravoxel incoherent motion (IVIM) parameters (D, D*, and f) of spleen were measured. Thirty-five subjects without pancreatic and splenic disorders were enrolled as controls for IVIM parameters. RESULTS: Among the 239 patients with AP, splenomegaly (16.7%), splenic infarction (0.4%), splenic vein thrombosis (4.2%), phlebitis (7.5%) and arteritis (4.2%) were observed. Splenic vascular involvement was positively correlated with the severity of AP based on both the MRSI and the New Revised Classification of AP 2012 (P<0.05). In the control and AP groups, the splenic f values were (0.164±0.074) vs. (0.210±0.095) (P=0.023) respectively. In AP patients with and without splenomegaly, f = (0.240±0.091) vs. (0.203±0.095) (P<0.001). CONCLUSIONS: Splenic vascular involvement and splenomegaly were common in AP. The vascular involvement was associated with the severity of AP. This complication should be considered when severity and prognosis of AP are assessed. Quantitative analysis of the spleen with IVIM might be a useful imaging biomarker for splenic perfusion changes in AP, especially in those with splenomegaly.
Entities:
Keywords:
Pancreas; acute pancreatitis (AP); magnetic resonance; spleen
Authors: Koenraad J Mortelé; Patricia J Mergo; Helena M Taylor; Walter Wiesner; Vito Cantisani; Michael D Ernst; Babak N Kalantari; Pablo R Ros Journal: Eur J Radiol Date: 2004-10 Impact factor: 3.528
Authors: A Djuric-Stefanovic; N Gordanic; D Saponjski; K Koljensic; J Djokic-Kovac; S Knezevic Journal: Surg Radiol Anat Date: 2019-03-13 Impact factor: 1.246
Authors: Chinenye R Dike; Gretchen Cress; Douglas S Fishman; Tanja Gonska; Chee Y Ooi; Emily R Perito; David Troendle; Cynthia M Tsai; Mark E Lowe; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2021-10-01 Impact factor: 3.288