Role of fat-suppressed t1-weighted magnetic resonance imaging in predicting severity and prognosis of acute pancreatitis: an intraindividual comparison with multidetector computed tomography.
OBJECTIVE
To determine the diagnostic value of magnetic resonance (MR) grading focusing on elevated signal on T1-weighted images in the prediction of severity and prognosis of acute pancreatitis as compared with the Balthazar computed tomography (CT) grading.


METHODS
Thirty-one patients with acute pancreatitis who underwent CT and MR imaging including fat-suppressed T1-weighted images within a 48-hour interval were included in this study. The severity of pancreatitis was evaluated by 2 observers using the Balthazar CT grading system and an MR grading system that is focused on an elevated signal on T1-weighted images. The MR grading was correlated with the CT grading, and each MR or CT grade was compared with patient outcome parameters, including the duration of hospitalization, local and systemic complications, and clinical outcome grading.


RESULTS
There was a significant correlation between CT and MR gradings for pancreatic or peripancreatic inflammation (r = 0.688, P < 0.01). However, for all of the outcome parameters and outcome grading, a stronger correlation was seen with the MR grading than with the CT grading. No significant correlation was found between CT grading and infected necrosis (r = 0.316, P = 0.083).


CONCLUSIONS
Magnetic resonance imaging including fat-suppressed T1-weighted images is more accurate to predict the severity and prognosis of acute pancreatitis in comparison with CT.
Kim
Young Kon
YK
Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Jeonju, South Korea. jmyr@dreamwiz.com
Kim
Chong Soo
CS
Han
Young Min
YM
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007902:Length of Stay; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*