Early Diagnosis and Severity Assessment of Acute Pancreatitis (AP) Using MR Elastography (MRE) With Spin-Echo Echo-Planar Imaging
Early Diagnosis and Severity Assessment of Acute Pancreatitis (AP) Using MR Elastography (MRE) With Spin-Echo Echo-Planar Imaging
复制标题
使用 MR 弹性成像 (MRE) 和自旋回波平面成像对急性胰腺炎 (AP) 进行早期诊断和严重程度评估
DOI：
10.1002/jmri.25679
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发表时间：
2017
影响因子：
4.4
通讯作者：
Guo Qi yong
中科院分区：
文献类型：
--
作者：
Shi Yu;Liu Ying;Liu Yan qing;Gao Feng;Li Jia hui;Li Qiu ju;Guo Qi yong
PurposeTo评估磁共振弹性成像（MRE）与对比增强计算机断层扫描（CE-CT）相比在急性胰腺炎（AP）早期诊断和严重程度预测中的准确性。Materials and MethodsThis cross-sectional prospective study纳入了76例疑似AP患者，这些患者在入院后24小时内接受了CE-CT和3.0T MRE。使用入院前24小时的数据对胰腺僵硬度、CT严重程度指数（CTSI）、急性生理学和慢性健康状况评价（APACHE）-II和AP严重程度床边指数（BISAP）评分进行了比较性评价，并根据修订后的亚特兰大分类（2012）确认了AP的诊断和严重程度。MRE预测疾病严重程度的准确性与CE-CT和临床评分系统使用受试者工作曲线下面积（AUC）analysis.ResultsAP被证实在56/76例（73.7%）。胰腺硬度值>1.47 kPa时的诊断性能明显优于CE‐CT（AUC：0.993 vs. 0.818，P < 0.001），沿着具有更高的灵敏度（96.4% vs. 78.6%，P = 0.006）和准确度（96.1% vs. 81.6%，P = 0.007）。10例患者（10/76; 13.2%）患有临床重度AP。胰腺硬度>2.47 kPa的准确性与CTSI、APACHE-II和BISAP评分预测重度AP的准确性相当（准确性分别为85.5%、75.0%、88.2%和78.9%）。经Bonferroni校正后，两两比较差异无统计学意义（P< 0.008 [0.05/6]），P值分别为0.008（MRE vs. CTSI）、0.823（MRE vs. APACHE-II）和0.414（MRE vs. BISAP）。我们建议在入院时进行MRE以初步评估AP。证据等级：1技术有效性：2 J期。Magn. Reson. Imaging 2017;46：1311-1319.
PurposeTo evaluate the accuracy of magnetic resonance elastography (MRE) in comparison to contrast‐enhanced computed tomography (CE‐CT) for early diagnosis and prediction of severity in acute pancreatitis (AP).Materials and MethodsThis cross‐sectional prospective study included 76 patients with suspected AP who underwent both CE‐CT and 3.0T MRE within 24 hours of hospital admission. Pancreatic stiffness, CT severity index (CTSI), Acute Physiology and Chronic Health Evaluation (APACHE)‐II, and Bedside Index for Severity in AP (BISAP) scores were comparatively evaluated using data from the first 24 hours of admission, and diagnosis and severity of AP were confirmed according to the revised Atlanta Classification (2012). The accuracy of MRE for predicting disease severity was compared with that of CE‐CT and the clinical scoring systems using area under the receiver‐operating curve (AUC) analysis.ResultsAP was confirmed in 56/76 patients (73.7%). Pancreatic stiffness values of >1.47 kPa showed significantly better diagnostic performance than CE‐CT (AUC: 0.993 vs. 0.818,P< 0.001) along with greater sensitivity (96.4% vs. 78.6%,P= 0.006) and accuracy (96.1% vs. 81.6%,P= 0.007). Ten patients (10/76; 13.2%) had clinically severe AP. The accuracy of pancreatic stiffness >2.47 kPa was comparable to that of the CTSI, APACHE‐II and BISAP scores for predicting severe AP (accuracy = 85.5%, 75.0%, 88.2%, and 78.9%, respectively). The pairwise comparisons were not significant after Bonferroni correction (P< 0.008 [0.05/6]), withPvalues of 0.008 (MRE vs. CTSI), 0.823 (MRE vs. APACHE‐II) and 0.414 (MRE vs. BISAP).ConclusionEarly MRE is a useful, noninvasive method for both diagnosis and early severity assessment of AP. We recommend MRE at hospital admission for initial evaluation of AP.Level of Evidence:1Technical Efficacy:Stage 2J. Magn. Reson. Imaging 2017;46:1311–1319.