title: Diffusion-weighted magnetic resonance imaging indicates the severity of acute pancreatitis.
abstract: OBJECTIVE
  To test the use of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate between different degrees of severity of acute pancreatitis (AP).
  
  
  METHODS
  Thirty-six patients who underwent DW-MRI and magnetic resonance cholangiopancreatography were divided into patients with mild AP (mAP, n = 15), patients with necrotizing AP (nAP, n = 8), and patients with a normal pancreas (nP, n = 15; controls). The pancreas was divided into head, body, and tail, and each segment was classified according to image features: pattern 1, normal; pattern 2, mild inflammation; and pattern 3, necrosis. Apparent diffusion coefficients (ADCs) were measured in each segment and correlated with clinical diagnoses.
  
  
  RESULTS
  A total of 108 segments was assessed (three segments per patient). Segments classified as pattern 1 in the nP and mAP groups showed similar ADC values (P = 0.29). ADC values calculated for the pancreatic segments grouped according to the different image patterns (1-3) were significantly different (P < 0.001). Comparisons revealed significant differences in signal intensity between all three patterns (P < 0.05).
  
  
  CONCLUSIONS
  DW-MRI was a compatible and safe image option to differentiate tissue image patterns in patients with mAP, nAP, and nP, mainly in those with contraindications to contrast-enhanced MRI (which is classically required for determining the presence of necrosis) or computed tomography. ADC measures allowed precise differentiation between patterns 1, 2, and 3.
authors: Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
authors: Franklin
authors: F
authors: de Freitas Tertulino
authors: Vladimir
authors: V
authors: Schraibman
authors: José Celso
authors: JC
authors: Ardengh
authors: Danilo Cerqueira
authors: DC
authors: do Espírito-Santo
authors: Sergio Aron
authors: SA
authors: Ajzen
authors: Franz Robert Apodaca
authors: FR
authors: Torrez
authors: Edson Jose
authors: EJ
authors: Lobo
authors: Jacob
authors: J
authors: Szejnfeld
authors: Suzan Menasce
authors: SM
authors: Goldman
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium