Published online Dec 28, 2013. doi: 10.4329/wjr.v5.i12.491
Revised: October 26, 2013
Accepted: November 18, 2013
Published online: December 28, 2013
AIM: To study the prevalence and patterns of hepatic abnormal perfusion (HAP) visible by magnetic resonance imaging (MRI) in acute pancreatitis (AP).
METHODS: Enhanced abdominal MRI was performed on 51 patients with AP. These patients were divided into two groups according to the MRI results: those with signs of gallstones, cholecystitis, common bile duct (CBD) stones or dilatation of the CBD on MRI and those without. The prevalence, shape and distribution of HAP in the two groups were analyzed and compared. The severity of AP was graded using the MR severity index (MRSI). The correlation between the MRSI and HAP was then analyzed.
RESULTS: Of the 51 patients with AP, 32 (63%) showed at least one sign of gallbladder and CBD abnormalities on the MR images, while 19 (37%) showed no sign of gallbladder or CBD abnormalities. Nineteen patients (37%) had HAP visible in the enhanced images, including strip-, wedge- or patch-shaped HAP distributed in the hepatic tissue adjacent to the gallbladder and left and right liver lobes. There were no significant differences in the prevalence of HAP (χ2 = 0.305, P = 0.581 > 0.05) or HAP distribution in the liver (χ2 = 2.181, P = 0.536 > 0.05) between patients with and without gallbladder and CBD abnormalities. There were no significant differences in the MRSI score between patients with and without HAP (t = 0.559, P = 0.552 > 0.05). HAP was not correlated with the MRSI score.
CONCLUSION: HAP is common in patients with AP and appears strip-, patch- or wedge-shaped on MRI. HAP on MRI cannot be used to indicate the severity of AP.
Core tip: Hepatic abnormal perfusion (HAP) due to acute pancreatitis on enhanced magnetic resonance imaging (MRI) presents as a strip-shaped abnormality of the hepatic tissue adjacent to the gallbladder or a patch- or wedge-shaped abnormality with lobar distribution in the liver, which is most likely caused by both the inflamed gallbladder and acute pancreatitis. Indications of HAP resulting from acute pancreatitis should not be misinterpreted as primary liver abnormalities. The presence of HAP on MRI cannot be used to indicate the severity of acute pancreatitis.