DIFFUSION WEIGHTED IMAGING AND ACUTE PANCREATITIS

 DIFFUSION WEIGHTED IMAGING AND ACUTE PANCREATITIS

Subtle art of diagnosing mild acute pancreatitis

         

Case (sequence of events)

- 23 /F

- Epigastric pain

- Ultrasound - hypoechoic and bulky pancreas. No peri-pancreatic fluid

- Lipase levels: 503 U/L (raised)

- MRI:

Key sequences:

1. T 2 W 3D 1 mm - Bulky with slight hyperintense signal. Subtle peripancreatic fat stranding / edema

2. DWI (b 800) - hyperintense signal

3. ADC: Restricted diffusion is seen

4. T 1 W FS- reduced signal (not shown)

Pearls:

-Acute inflamed pancreatitis demonstrates restricted diffusion

-MRI has the potential to replace CT Scan as primary diagnostic approach without giving contrast agents

-In addition MRCP provides information on biliary tree

https://www.omicsonline.org/open-access/the-role-of-diffusion-weighted-mr-imaging-in-the-diagnosis-of-acute-pancreatitis-1522-4821-16-117.php?aid=30342

Companion case to a early changes of pancreatitis in CT Scan:

httpsabdominalimaging.blogspot.comearly acute pancreatitisCT scanblog-post.html