Brief Article
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World J Radiol. Dec 28, 2013; 5(12): 491-497
Published online Dec 28, 2013. doi: 10.4329/wjr.v5.i12.491
Hepatic abnormal perfusion visible by magnetic resonance imaging in acute pancreatitis
Wei Tang, Xiao-Ming Zhang, Zhao-Hua Zhai, Nan-Lin Zeng
Wei Tang, Xiao-Ming Zhang, Zhao-Hua Zhai, Nan-Lin Zeng, Sichuan Key Laboratory of Medical Image, Radiology Department, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Tang W performed the majority of the procedures and wrote the manuscript; Zhang XM was involved in the conception and design of the study; Zhang XM and Zhai ZH edited the manuscript; and Zeng NL contributed to the data analysis and interpretation.
Correspondence to: Dr. Wei Tang, Sichuan Key Laboratory of Medical Image, Radiology Department, Affiliated Hospital of North Sichuan Medical College, Wenhua Road No. 63, Shunqing District, Nanchong 637000, Sichuan Province, China. tw-n-g-up@163.com
Telephone: +86-817-2262218 Fax: +86-817-2222856
Received: September 5, 2013
Revised: October 26, 2013
Accepted: November 18, 2013
Published online: December 28, 2013
Processing time: 123 Days and 1.7 Hours
Abstract

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.

Keywords: Pancreatitis; Hepatic abnormal perfusion; Magnetic resonance imaging; Gallbladder

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.