Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, Sichuan 637000, China.
Sichuan Key Laboratory of Medical Imaging and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No. 63, Wenhua Road, Nanchong, Sichuan 637000, China.
Acad Radiol. 2021 Nov;28 Suppl 1:S225-S233. doi: 10.1016/j.acra.2019.10.023. Epub 2019 Nov 23.
To study the MRI characteristics of early extrapancreatic necrosis and compare them with those of peripancreatic fluid collections in acute pancreatitis (AP).
This retrospective study enrolled 70 AP patients who had extrapancreatic collections visible on MRI within 1 week of onset. Extrapancreatic collections were divided into extrapancreatic necrosis and peripancreatic fluid collections based on follow-up MRI, CT, or pathology. The number and area of extrapancreatic collections, extrapancreatic inflammation on MRI (EPIM) score, MR severity index score and clinical characteristics were evaluated and compared between the two groups.
Of the seventy AP patients, 32 (45.7%) had extrapancreatic necrosis, and 38 (54.3%) had peripancreatic fluid collections. The number and area of extrapancreatic collections, MR severity index score, EPIM score, and prevalence of associated hemorrhage were significantly higher in extrapancreatic necrosis patients than in those with peripancreatic fluid collections (p < 0.001). Among the single indicators, the accuracy of the area of extrapancreatic collections (AUC = 0.871) was comparable to that of the EPIM score for predicting extrapancreatic necrosis and was significantly higher than that of the other two indicators. The combination of all indicators showed the highest predictive accuracy (AUC = 0.949), and combinations of two or more indicators demonstrated significantly higher predictive accuracy for extrapancreatic necrosis than any single indicator (p < 0.05) except for the area of extrapancreatic collections (p > 0.05).
The MRI characteristics have the potential to differentiate early extrapancreatic necrosis from peripancreatic fluid collections and help indicate extrapancreatic necrosis.
研究急性胰腺炎（AP）早期胰外坏死的 MRI 特征，并与胰周积液进行比较。
本回顾性研究纳入了 70 例 AP 患者，这些患者在发病后 1 周内 MRI 可见胰外积液。根据随访 MRI、CT 或病理将胰外积液分为胰外坏死和胰周积液。评估并比较两组患者的胰外积液数量和面积、MRI 胰外炎症评分（EPIM）、MR 严重指数评分和临床特征。
在 70 例 AP 患者中，32 例（45.7%）有胰外坏死，38 例（54.3%）有胰周积液。胰外坏死患者胰外积液数量和面积、MR 严重指数评分、EPIM 评分和合并出血的发生率均显著高于胰周积液患者（p < 0.001）。在单一指标中，胰外积液面积的准确性（AUC=0.871）与 EPIM 评分相当，预测胰外坏死的准确性明显高于其他两个指标。所有指标的组合具有最高的预测准确性（AUC=0.949），且两个或更多指标的组合预测胰外坏死的准确性明显高于任何单一指标（p < 0.05），但胰外积液面积除外（p > 0.05）。
MRI 特征可区分早期胰外坏死与胰周积液，有助于提示胰外坏死。
