Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229.
Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH.
AJR Am J Roentgenol. 2024 Jan;222(1):e2329940. doi: 10.2214/AJR.23.29940. Epub 2023 Aug 30.
Imaging plays an important role in the diagnosis and follow-up of children with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP). Consensus is lacking for a minimum MRI protocol for the child with known or suspected ARP or CP. Lack of standardization contributes to variable diagnostic performance and hampers application of uniform interpretive criteria for clinical diagnosis and multicenter research studies. We convened a working group to achieve consensus for a minimum MRI protocol for children with suspected ARP or CP. The group included eight pediatric radiologists experienced in interpreting MRI for pediatric pancreatitis and one medical pancreatologist and functioned from November 2022 to March 2023. Existing clinical protocols were summarized across sites represented by group members, and commonly used sequences guided the group's discussion. The final consensus minimum MRI protocol includes five noncontrast sequences and two postcontrast sequences (which are required only in select clinical scenarios). The working group also provides recommended acquisition parameters, sequence-specific technical suggestions, and general recommendations for optimal imaging technique. We recommend that all sites imaging children with ARP and CP for clinical care, and particularly those engaged in cooperative group trials for pancreatitis, ensure that their local protocol includes these minimum sequences.
影像学在儿童急性复发性胰腺炎(ARP)和慢性胰腺炎(CP)的诊断和随访中起着重要作用。对于已知或疑似 ARP 或 CP 的儿童,缺乏最小 MRI 方案的共识。缺乏标准化导致诊断性能的差异,并阻碍了临床诊断和多中心研究中统一解释标准的应用。我们召集了一个工作组,以就疑似 ARP 或 CP 的儿童的最小 MRI 方案达成共识。该小组包括 8 名在儿童胰腺炎 MRI 解读方面经验丰富的儿科放射科医生和 1 名医学胰腺病专家,从 2022 年 11 月至 2023 年 3 月开展工作。小组成员所在的各个站点总结了现有的临床方案,并根据常用序列指导小组的讨论。最终的共识最小 MRI 方案包括五个非对比序列和两个对比后序列(仅在特定临床情况下需要)。工作组还提供了推荐的采集参数、特定序列的技术建议以及最佳成像技术的一般建议。我们建议所有为临床护理而对 ARP 和 CP 患儿进行成像的站点,特别是参与胰腺炎合作组试验的站点,确保其当地方案包含这些最小序列。