Share this content in WeChat
The advances of MRI in the clinical pathway of acute pancreatitis
XIAO Ran  XUE Huadan 

Cite this article as: Xiao R, Xue HD. The advances of MRI in the clinical pathway of acute pancreatitis[J]. Chin J Magn Reson Imaging, 2022, 13(1): 164-166. DOI:10.12015/issn.1674-8034.2022.01.039.

[Abstract] Acute pancreatitis is a common clinical acute abdomen with local and systematic complications. According to clinical manifestations and prognosis, the revised Atlanta classification defines three degrees of severity: mild acute pancreatitis, moderately severe acute pancreatitis, and severe acute pancreatitis. In recent years, incidence rate of acute pancreatitis increases gradually and mortality is relatively high in severe acute pancreatitis. Computed tomography, ultrasound and magnetic resonance imaging (MRI) are common radiological technologies in acute pancreatitis clinically. Owing to multiple imaging parameters, MRI has excellent soft tissue contrast resolution and good evaluation capability of biliary and pancreatic duct. Despite the application in morphology, advanced MR techniques such as diffusion-weighted imaging and radiomics, help uncover underlying changes of pancreas and imaging biomarkers for classification and prognosis. Numerous studies use MRI to explore various factors related to the severity and prognosis of acute pancreatitis. The purpose of this article is to review the application advances of MRI in acute pancreatitis in recent years.
[Keywords] acute pancreatitis;magnetic resonance imaging;diagnosis;local complications;severity;prognosis

XIAO Ran   XUE Huadan*  

Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China.

Xue HD, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS National Natural Science Foundation of China (No. 81871512).
Received  2021-09-06
Accepted  2021-12-31
DOI: 10.12015/issn.1674-8034.2022.01.039
Cite this article as: Xiao R, Xue HD. The advances of MRI in the clinical pathway of acute pancreatitis[J]. Chin J Magn Reson Imaging, 2022, 13(1): 164-166. DOI:10.12015/issn.1674-8034.2022.01.039.

Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779.
Xiao B, Zhang XM, Tang W, et al. Magnetic resonance imaging for local complications of acute pancreatitis: a pictorial review[J]. World J Gastroenterol, 2010, 16(22): 2735-2742. DOI: 10.3748/wjg.v16.i22.2735.
Xiao B, Xu HB, Jiang ZQ, et al. Current concepts for the diagnosis of acute pancreatitis by multiparametric magnetic resonance imaging[J]. Quant Imaging Med Surg, 2019, 9(12): 1973-1985. DOI: 10.21037/qims.2019.11.10.
Sun H, Zuo HD, Lin Q, et al. MR imaging for acute pancreatitis: the current status of clinical applications[J]. Ann Transl Med, 2019, 7(12): 269. DOI: 10.21037/atm.2019.05.37.
Yang DD, Zuo HD, Wu CQ, et al. The characteristics of acute necrotizing pancreatitis in different age stages: An MRI study[J]. Eur J Radiol, 2020, 122: 108752. DOI: 10.1016/j.ejrad.2019.108752.
Lecesne R, Taourel P, Bret PM, et al. Acute pancreatitis: interobserver agreement and correlation of CT and MR cholangiopancreatography with outcome[J]. Radiology, 1999, 211(3): 727-735. DOI: 10.1148/radiology.211.3.r99jn08727.
Stimac D, Miletić D, Radić M, et al. The role of nonenhanced magnetic resonance imaging in the early assessment of acute pancreatitis[J]. Am J Gastroenterol, 2007, 102(5): 997-1004. DOI: 10.1111/j.1572-0241.2007.01164.x.
Bálint ER, Fűr G, Kiss L, et al. Assessment of the course of acute pancreatitis in the light of aetiology: a systematic review and meta-analysis[J]. Sci Rep, 2020, 10(1): 17936. DOI: 10.1038/s41598-020-74943-8.
Barlow AD, Haqq J, McCormack D, et al. The role of magnetic resonance cholangiopancreatography in the management of acute gallstone pancreatitis[J]. Ann R Coll Surg Engl, 2013, 95(7): 503-506. DOI: 10.1308/003588413x13629960049036.
Zhou T, Tang MY, Deng Y, et al. MR Imaging for Early Extrapancreatic Necrosis in Acute Pancreatitis[J]. Acad Radiol, 2019. DOI: 10.1016/j.acra.2019.10.023.
Rana SS. An overview of walled-off pancreatic necrosis for clinicians[J]. Expert Rev Gastroenterol Hepatol, 2019, 13(4): 331-343. DOI: 10.1080/17474124.2019.1574568.
Islim F, Salik AE, Bayramoglu S, et al. Non-invasive detection of infection in acute pancreatic and acute necrotic collections with diffusion-weighted magnetic resonance imaging: preliminary findings[J]. Abdominal imaging, 2014, 39(3): 472-481. DOI: 10.1007/s00261-014-0076-2.
Sandrasegaran K, Tahir B, Barad U, et al. The Value of Secretin-Enhanced MRCP in Patients With Recurrent Acute Pancreatitis[J]. AJR Am J Roentgenol, 2017, 208(2): 315-321. DOI: 10.2214/ajr.16.16566.
Swensson J, Zaheer A, Conwell D, et al. Secretin-Enhanced MRCP: How and Why-AJR Expert Panel Narrative Review[J]. AJR Am J Roentgenol, 2021, 216(5): 1139-1149. DOI: 10.2214/ajr.20.24857.
Iranmahboob AK, Kierans AS, Huang C, et al. Preliminary investigation of whole-pancreas 3D histogram ADC metrics for predicting progression of acute pancreatitis[J]. Clin Imaging, 2017, 42: 172-177. DOI: 10.1016/j.clinimag.2016.12.007.
Arvanitakis M, Delhaye M, De Maertelaere V, et al. Computed tomography and magnetic resonance imaging in the assessment of acute pancreatitis[J]. Gastroenterology, 2004, 126(3): 715-723. DOI: 10.1053/j.gastro.2003.12.006.
Zhou T, Chen Y, Wu JL, et al. Extrapancreatic Inflammation on Magnetic Resonance Imaging for the Early Prediction of Acute Pancreatitis Severity[J]. Pancreas, 2020, 49(1): 46-52. DOI: 10.1097/mpa.0000000000001425.
Li X, Zhuang L, Zhang X, et al. Preliminary Study of MR Diffusion Tensor Imaging of Pancreas for the Diagnosis of Acute Pancreatitis[J]. PloS one, 2016, 11(9): e0160115. DOI: 10.1371/journal.pone.0160115.
Shi Y, Liu Y, Liu YQ, et al. Early diagnosis and severity assessment of acute pancreatitis (AP) using MR elastography (MRE) with spin-echo echo-planar imaging[J]. J Magn Reson Imaging, 2017, 46(5): 1311-1319. DOI: 10.1002/jmri.25679.
Lin Q, Ji YF, Chen Y, et al. Radiomics model of contrast-enhanced MRI for early prediction of acute pancreatitis severity[J]. J Magn Reson Imaging, 2020, 51(2): 397-406. DOI: 10.1002/jmri.26798.
Hu R, Yang H, Chen Y, et al. Dynamic Contrast-Enhanced MRI for Measuring Pancreatic Perfusion in Acute Pancreatitis: A Preliminary Study[J]. Acad Radiol, 2019, 26(12): 1641-1649. DOI: 10.1016/j.acra.2019.02.007.
Li XH, Zhu J, Zhang XM, et al. Abdominal MRI at 3.0 T: LAVA-Flex compared with conventional fat suppression T1-weighted images[J]. J Magn Reson Imaging, 2014, 40(1): 58-66. DOI: 10.1002/jmri.24329.
Tang MY, Chen TW, Bollen TL, et al. MR imaging of hemorrhage associated with acute pancreatitis[J]. Pancreatology, 2018, 18(4): 363-369. DOI: 10.1016/j.pan.2018.03.004.
Lankisch PG, Weber-Dany B, Maisonneuve P, et al. Skin signs in acute pancreatitis: frequency and implications for prognosis[J]. J Intern Med, 2009, 265(2): 299-301. DOI: 10.1111/j.1365-2796.2008.02004.x.
Liu H, Li W, Wang X, et al. Early gut mucosal dysfunction in patients with acute pancreatitis[J]. Pancreas, 2008, 36(2): 192-196. DOI: 10.1097/MPA.0b013e31815a399f.
Yang R, Jing ZL, Zhang XM, et al. MR imaging of acute pancreatitis: correlation of abdominal wall edema with severity scores[J]. Eur J Radiol, 2012, 81(11): 3041-3047. DOI: 10.1016/j.ejrad.2012.04.005.
Ji YF, Zhang XM, Mitchell DG, et al. Gastrointestinal tract involvement in acute pancreatitis: initial findings and follow-up by magnetic resonance imaging[J]. Quant Imaging Med Surg, 2017, 7(6): 641-653. DOI: 10.21037/qims.2017.12.03.
Jiang ZQ, Xiao B, Zhang XM, et al. Early-phase vascular involvement is associated with acute pancreatitis severity: a magnetic resonance imaging study[J]. Quant Imaging Med Surg, 2021, 11(5): 1909-1920. DOI: 10.21037/qims-20-280.
Li XH, Zhang XM, Ji YF, et al. Renal and perirenal space involvement in acute pancreatitis: An MRI study[J]. Eur J Radiol, 2012, 81(8): e880-887. DOI: 10.1016/j.ejrad.2012.04.032.
Sankaran SJ, Xiao AY, Wu LM, et al. Frequency of progression from acute to chronic pancreatitis and risk factors: a meta-analysis[J]. Gastroenterology, 2015, 149(6): 1490-1500.e1. DOI: 10.1053/j.gastro.2015.07.066.
Modesto AE, Stuart CE, Cho J, et al. Psoas muscle size as a magnetic resonance imaging biomarker of progression of pancreatitis[J]. Eur Radiol, 2020, 30(5): 2902-2911. DOI: 10.1007/s00330-019-06633-7.
DeSouza SV, Priya S, Cho J, et al. Pancreas shrinkage following recurrent acute pancreatitis: an MRI study[J]. Eur Radiol, 2019, 29(7): 3746-3756. DOI: 10.1007/s00330-019-06126-7.

PREV The basic principle of intravoxel incoherent motion imaging and its application progress in Sjogren,s syndrome
NEXT Principle and clinical application of high resolution magnetic resonance diffusion imaging with multiplexed sensitivity encoding

Tel & Fax: +8610-67113815    E-mail: