4.6 Article

The role of imaging in acute pancreatitis

Journal

RADIOLOGIA MEDICA
Volume 126, Issue 8, Pages 1017-1029

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s11547-021-01359-3

Keywords

Acute pancreatitis; Computed tomography (CT); MRI; Magnetic resonance cholangiopancreatography (MRCP); Interstitial edematous pancreatitis; Necrotizing Pancreatitis

Funding

  1. Universita Cattolica del Sacro Cuore within the CRUI-CARE Agreement

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Acute pancreatitis, ranging from mild to severe forms with significant complications, is commonly diagnosed and evaluated using ultrasound, CT, and MRI. CT is the most frequently performed imaging test, while MRI is advantageous in specific situations for better soft tissue contrast resolution and evaluation of ductal disconnection. The revised Atlanta classification system aids radiologists in writing accurate reports and highlights their crucial role in the multidisciplinary team for treating patients with acute pancreatitis.
Acute pancreatitis is one of the most commonly encountered etiologies in the emergency setting, with a broad spectrum of findings that varies in severity from mild interstitial pancreas to severe forms with significant local and systemic complications that are associated with a substantial degree of morbidity and mortality. In this article the radiological aspect of the terminology and classification of acute pancreatitis are reviewed. The roles of ultrasound, computed tomography, and magnetic resonance imaging in the diagnosis and evaluation of acute pancreatitis and its complications are discussed. The authors present a practical image-rich guide, applying the revised Atlanta classification system, with the goal of facilitating radiologists to write a correct report, and reinforcing the radiologist's role as a key member of a multidisciplinary team in treating patients with acute pancreatitis. Computed tomography is the most performed imaging test for acute pancreatitis. Nevertheless, MRI is useful in many specific situations, due to its superiority soft tissue contrast resolution and better assessment of biliary and pancreatic duct, for example in the ductal disconnection. The purpose if this article is to review recent advances in imaging acquisition and analytic techniques in the evaluation of AP.

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