The Role of Magnetic Resonance Imaging in Preliminary Screening as a Diagnostic Hallmark of Early Acute Pancreatitis
Keywords:
Acute pancreatitis, Early diagnosis, Imaging, MRI, Screening, Serum amylaseAbstract
Background: Early diagnosis of acute pancreatitis remains challenging when ultrasonography (USG) and computed tomography (CT) findings are inconclusive. Magnetic resonance imaging (MRI) provides superior soft-tissue contrast and early pathological visualization.
Objective: To evaluate the diagnostic effectiveness of MRI in detecting early acute pancreatitis in patients with negative USG and CT findings but positive serum amylase levels.
Methods: This prospective cross-sectional study was conducted at Ibne Sina Diagnostic & Consultation Center (Uttara), Popular Diagnostic Center (Savar), Super Medical Hospital (Savar) And Enam Medical College Hospital (Savar), Dhaka, Bangladesh, from January 2021 to July 2022. A total of 53 patients with acute abdominal pain and elevated serum amylase and lipase, but negative USG and CT findings, were included. MRI was performed using T1, T2, fat-suppressed, and diffusion-weighted sequences to detect early features of pancreatitis.
Result: MRI demonstrated a diagnostic sensitivity of 92.5% (49/53 patients), significantly surpassing CT and USG (p<0.001). While conventional T2/STIR sequences identified pancreatic enlargement (88.7%) and edema (84.9%), the DWI/ADC combination was pivotal. All positive cases exhibited restricted diffusion, quantified by a significantly lower mean ADC value in inflamed tissue (1.10 ± 0.14 x 10⁻³ mm²/s) versus normal tissue (1.51 ± 0.12 × 10⁻³ mm²/s; p<0.001). Conclusion: MRI, with its functional DWI/ADC component, is a highly sensitive non-invasive tool for the preliminary screening and diagnosis of early acute pancreatitis, serving as a crucial diagnostic hallmark when traditional imaging fails.
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