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Query: UMLS:C0001339 (acute pancreatitis)
 10,593 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pancreatic encephalopathy is an uncommon condition found in patients with acute pancreatitis. The present report shows the interest of MRI in the diagnosis of this disorder. Patchy white matter signal abnormalities, resembling plaques seen in multiple sclerosis, may reflect the lesions that are found in the cerebral white matter of post-mortem confirmed cases.
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PMID:Pancreatic encephalopathy. A case report and review of the literature. 165 95

The role of diagnostic imaging modalities in pancreatic inflammatory diseases is to assess gland damage and peripancreatic tissue involvement. The artifacts related to breathing and to peristaltic movements can be partially resolved with the optimization of acquisition parameters, which allows MRI to be suggested for the assessment of pancreatic inflammatory conditions. Sixty-nine patients with pancreatic inflammatory diseases (20 acute and 49 chronic pancreatitis cases) were examined. MRI was performed with a 0.5-T superconductive magnet and T1- and T2-weighted spin-echo (SE) sequences. In 4 of 20 acute pancreatitis patients image quality was poor. MRI in acute pancreatitis demonstrated glandular edema, intraparenchymal necrosis and the extent of peripancreatic fluid collections; in chronic pancreatitis MRI depicted glandular atrophy and Wirsung duct dilatation and detected the presence of pseudocysts. Even though its spatial resolution is lower than that of CT, MRI can provide useful pieces of information in inflammatory diseases of the pancreas, much more so after the introduction of Fast SE sequences and of fat-saturation techniques which are likely to make MR examinations of the pancreas more widely used.
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PMID:[Magnetic resonance in the study of inflammatory diseases of the pancreas]. 756 98

We discuss the usefulness of MR examination in the diagnosis of pancreatic diseases, in addition to the other available imaging techniques. MR imaging yields important information in diagnosis and staging of pancreatic tumours, and in the characterization of pancreatic masses. MRI is also valuable for the study of chronic as well as acute pancreatitis, although there are some limits such as the poor detection of calcifications in the chronic, and the excessively long time required to complete the examination in the acute form.
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PMID:[Images of pancreatic pathology: advantages and limitations of magnetic resonance compared with computerized tomography and ultrasound]. 795 61

Magnetic resonance imaging was performed at 1.0 T in seven patients with severe acute pancreatitis. A T2-weighted spin echo sequence and a breath-hold multislice rapid gradient echo sequence (TurboFLASH) were used in each patient. TurboFLASH imaging was performed before and after intravenous gadopentetate-dimeglumine (Gd-DTPA). All MRI images were compared with a recent contrast-enhanced CT scan. Postgadolinium MRI was equivalent to contrast-enhanced CT in differentiating viable pancreatic parenchyma from areas of pancreatic necrosis. MRI identified the presence of gas in a case of pancreatic abscess but failed to identify small foci of pancreatic calcification demonstrated in one case by CT. MRI was also equivalent to CT in assessing the location and extent of peripancreatic inflammatory changes and fluid collections. However, MRI, particularly the T2-weighted spin echo, was superior to CT in characterizing the complex nature of such inflammatory changes in one case. Initial experience suggests that MRI is a valuable technique in assessing patients with severe acute pancreatitis.
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PMID:Comparison of MR and CT scanning in severe acute pancreatitis: initial experiences. 800 88

Until few years ago, MR assessment of pancreatic carcinoma was thought to be feasible only with high-strength equipment, but today also low- and midfield units allow pancreatic lesion detection, thanks to parameter optimization. The authors retrospectively analyzed the MR findings of 57 patients examined with a midfield MR unit; all the patients had clinically suspected pancreatic carcinoma, which was confirmed in 54 cases. The lesions were more easily detected using T1-weighted sequences, thanks to their high intrinsic contrast, while T2-weighted sequences often confirmed the glandular changes already depicted by T1-weighted sequences. MRI correctly depicted vascular and lymph node involvement and detected liver metastases with no i.v. contrast agent injection. The only limitations of this technique are the unfeasibility of MR exams of diagnostic value in uncooperative patients (5% of cases) and the very similar MR features of parenchymal scars, due to previous acute pancreatitis, to those of pancreatic carcinoma. In conclusion, CT remains the gold standard in the study of pancreatic cancers, but midfield strength MRI, if correctly performed, can be proposed as a complementary tool to CT, especially in questionable cases and in the patients with known reactions to iodinated contrast agents.
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PMID:[Carcinoma of the pancreas. Typical and atypical aspects using midfield-strength magnetic resonance]. 868 58

The purpose of this study was to compare T2-weighted and dynamic contrast enhanced MRI with contrast enhanced CT in patients with severe acute pancreatitis. Thirty-two patients were examined using axial T2-weighted spin-echo imaging (TR 1801, TE 15/90) and a multi-slice rapid gradient-echo sequence (TR 135, TE 4, FA 80 degrees) (FLASH) in axial and coronal planes. Fifteen 5 mm axial slices at 10 mm intervals were acquired during a single breath-hold of 19 s before, and at 10 and 40 s after a bolus injection of Gd-DTPA. Additional FLASH images in the coronal plane were obtained 2 min after injection of contrast medium. MR was compared with contemporary enhanced CT by two blinded observers who scored pancreatic viability and the content of intra and extra-pancreatic fluid collections. The presence of gas, calcification and haemorrhage was noted. Abnormalities in adjacent organs, evidence of vascular occlusion and indicators of aetiology were also recorded. MR and CT were concordant in distinguishing viable pancreatic tissue from areas of necrosis. MR appeared to be more effective than CT in characterizing the content of fluid collections and in demonstrating gall stones, although CT remains superior in detecting flecks of gas and calcification. MR carries some advantages over CT and can be regarded as an alternative primary technique in patients with severe pancreatitis.
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PMID:T2-weighted and dynamic enhanced MRI in acute pancreatitis: comparison with contrast enhanced CT. 904 43

The pseudocyst of the pancreas is a frequent complication of acute pancreatitis. The splenic involvement from the pancreatic pseudocyst is an uncommon entity. A 40-year-old man, who had a five-year history of alcohol consumption, was referred to our hospital for treatment of throbbing pain over left upper quadrant (LUQ) of the abdomen. Except for LUQ tenderness, physical examination was essentially normal. MRI showed two cystic lesions in splenic hilum and pancreatic tail, and prominent vessels in left infrasplenic area and gastrosplenic ligament. Angiography revealed splenic vein thrombosis. Because of persistent LUQ pain, he underwent laparotomy. During the operation, we found the cysts in pancreatic tail and splenic hilum. The cystic content was aspirated to check amylase, which showed the level of amylase being as high as 20,000 IU/L. The diagnosis of a pancreatic pseudocyst involving the spleen was established. Splenectomy and distal pancreatectomy were performed to remove both cysts. The pathologic examination of the resected spleen showed splenic infarction with cyst formation and pancreatic pseudocyst. The patient recovered uneventfully after operation.
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PMID:Pancreatic pseudocyst involving the spleen. 978 Jun 4

It is of utmost importance to assess the severity of acute pancreatitis immediately in order to identify patients with severe or necrotising disease who can benefit from early intensive care therapy. Additionally, in face of new therapeutic concepts (e.g., antibiotic therapy) and for the evaluation of new drugs (e.g. PAF antagonist) patients should be staged as soon as possible into mild and severe disease. At hospital admission it is not possible to assess the severity on a clinical basis. The "gold standard" up to now has been imaging procedures (contrast-enhanced CT and MRI) which should be preserved for the severe cases to estimate the extent of pancreatic necrosis. The ideal predictor in blood/urine should be objective, reliable, cheap, easy to measure, and available every time and should have on hospital admission a high efficacy and independence from other diseases. As single factors there are a variety of mediators of the "systemic inflammatory response syndrome" which are elevated in this disease (C-reactive protein, antiproteases, enzyme activation peptides, PMN-elastase, complement factors, interleukines and chemokines, etc.). Among all these prognostic indicators, C-reactive protein is now the best analyzed parameter. However, one should take into account that its highest efficacy is reached 3-4 days after onset of disease.
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PMID:[Definition of predictors of a complicated course in acute pancreatitis]. 993 53

The aim of the study was to assess the ability of MRI to differentiate between the two forms of severity of acute pancreatitis (AP), which is important for the detection of patients who require intensive monitoring and therapy. The second objective was to evaluate whether the distinction would be possible regardless of the MRI equipment. Magnetic resonance imaging was performed before and after intravenous administration of a gadolinium (Gd) chelate at 1.0 T using the breath-hold multislice rapid gradient-echo turbo fast low-angle shot (FLASH) sequence in 14 patients, and at 1.5 T with the 2D FLASH(50) sequence with fat saturation in 18 patients with acute pancreatitis early in the course of the disease. The patients were classified according to the Atlanta classification system as having the mild (MAP) or severe (SAP) form of the disease. At 1.0 T with use of a body coil, contrast-enhanced MRI failed to distinguish mild from severe pancreatitis. At 1.5 T with a phased-array body coil, the signal intensities of the patients with SAP were statistically significantly lower than those of the MAP group. Our initial clinical experience suggests that MRI with a sufficient magnetic field gradient strength may be useful for separating the two forms of acute pancreatitis in their early phases.
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PMID:Detection of severe acute pancreatitis by contrast-enhanced magnetic resonance imaging. 1066 68

We describe here a 71-year-old man who had herpes zoster encephalitis. He developed high fever, headache and disturbance of consciousness on 1st, May, 1998. On admission, neurological examination revealed disturbance of consciousness with restlessness and meningeal signs. Brain MRI (T 1 and T 2 weighted images) demonstrated high signal lesions in the left temporal lobe and cerebellar vermis. VSV encephalitis was diagnosed based on CSF pleocytosis, high serum and CSF titers of VZV antibody and EEG abnormality. During hospitalization, Ramsay-Hunt syndrome, herpes zoster generalisatus and acute pancreatitis developed. To our knowledge, the characteristic combination of the clinical signs in this case is very rare. We discussed the pathogenic mechanisms of these conditions, and this case was considered to have VZV encephalitis, and to be associated with right facial nerve palsy and pancreatitis, in spite of the absence of immunological deficiency.
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PMID:[A case of herpes zoster encephalitis with Ramsay-Hunt syndrome, herpes zoster generalisatus and acute pancreatitis]. 1068 90


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