caa a22 4500 605495556 CHVBK 20210128100532.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00261-014-0205-y doi (NATIONALLICENCE)springer-10.1007/s00261-014-0205-y Diffusion-weighted magnetic resonance imaging indicates the severity of acute pancreatitis [Elektronische Daten] [Franklin de Freitas Tertulino, Vladimir Schraibman, José Ardengh, Danilo do Espírito-Santo, Sergio Ajzen, Franz Torrez, Edson Lobo, Jacob Szejnfeld, Suzan Goldman] Purpose: To test the use of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate between different degrees of severity of acute pancreatitis (AP). Method: Thirty-six patients who underwent DW-MRI and magnetic resonance cholangiopancreatography were divided into patients with mild AP (mAP, n=15), patients with necrotizing AP (nAP, n=8), and patients with a normal pancreas (nP, n=15; controls). The pancreas was divided into head, body, and tail, and each segment was classified according to image features: pattern 1, normal; pattern 2, mild inflammation; and pattern 3, necrosis. Apparent diffusion coefficients (ADCs) were measured in each segment and correlated with clinical diagnoses. Results: A total of 108 segments was assessed (three segments per patient). Segments classified as pattern 1 in the nP and mAP groups showed similar ADC values (P=0.29). ADC values calculated for the pancreatic segments grouped according to the different image patterns (1-3) were significantly different (P<0.001). Comparisons revealed significant differences in signal intensity between all three patterns (P<0.05). Conclusions: DW-MRI was a compatible and safe image option to differentiate tissue image patterns in patients with mAP, nAP, and nP, mainly in those with contraindications to contrast-enhanced MRI (which is classically required for determining the presence of necrosis) or computed tomography. ADC measures allowed precise differentiation between patterns 1, 2, and 3. Springer Science+Business Media New York, 2014 Acute necrotizing pancreatitis nationallicence Diffusion magnetic resonance imaging nationallicence Differential diagnosis nationallicence de Freitas Tertulino Franklin Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Schraibman Vladimir Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Ardengh José Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut do Espírito-Santo Danilo Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Ajzen Sergio Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Torrez Franz Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Lobo Edson Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Szejnfeld Jacob Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Goldman Suzan Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 265-271 0942-8925 40:2<265 2015 40 261 https://doi.org/10.1007/s00261-014-0205-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0205-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- de Freitas Tertulino Franklin Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Schraibman Vladimir Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Ardengh José Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- do Espírito-Santo Danilo Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Ajzen Sergio Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Torrez Franz Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Lobo Edson Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Szejnfeld Jacob Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 700 1- Goldman Suzan Department of Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/2(2015-02-01), 265-271 0942-8925 40:2<265 2015 40 261