| Objective: To study MRI findings of gastrointestinal tract involvementin the early acute pancreatitis (AP) as well as correlations betweengastrointestinal tract abnormalities and the severity of acute pancreatitisaccording to the MR severity index (MRSI) and the Acute Physiology AndChronic Healthy EvaluationⅡ (APACHE Ⅱ) scoring system.Materials and Methods: A total of209patients with AP admitted to ourinstitution from October2010to April2012and100patients without AP forgastrointestinal tract abnormalities were included in this study. MRI wasperformed within48hour after admission. MRI findings of acute pancreatitiswere noted. The gastrointestinal tract abnormalities were noted in AP and inthe control groups and were compared by using the Chi Square Test or Fisherexact test. The changes of the wall and dimension of gastrointestinal tract,distribution and so on according to anatomy segment were noted. The severityof acute pancreatitis was studied using both the MRSI and theAPACHEⅡscoring system. Spearman correlation of gastrointestinal tractinvolvement with the MRSI and the APACHEⅡscoring system was analyzed.Results：In209patients with AP,87%of patients were edematous and13%of patients were necrotizing on MR imaging. There were67%,28%and5%of patients had mild, moderate and severe AP respectively according to MRSI.63%(132/209) of AP patients had at least one gastrointestinal tractabnormality and5%patients of control groups had gastrointestinal tractabnormality on MR imaging (P<0.05). The abnormality for AP patientsincluding thickened stomach wall (20%), thickened duodenum wall (27%),thickened jejunum wall (10%), thickened ileum wall (4%), thickenedascending colon wall (11%), thickened transverse colon wall (18%),thickened descending colon wall (28%), flatulence (8%) and so on.100%(27/27) of patients with necrotizing AP had gastrointestinal tractabnormality, which was significantly higher than72%(105/182) of patientswith edematous AP (p<0.05). The prevalence of gastrointestinal tractabnormality were47%in mild AP,93％in moderate AP and100%in severeAP respectively (among three groups, P<0.05). Gastrointestinal tractabnormality was correlated with the MRSI score (r=0.457, P<0.05) and it wasslightly correlated with the APACHE II score (r=0.193, P<0.05).Conclusion: Most patients with AP show gastrointestinal tractabnormality on MRI imaging, including thickened gastrointestinal tract wall,flatulence. The prevalence of gastrointestinal tract abnormality has a positivecorrelation with the severity of AP on MRI. Objective: To study MRI follow-up of gastrointestinal tract in acutepancreatitis (AP) as well as correlations between gastrointestinal tract abnormalities and the clinical feature.Materials and Methods: A total of62patients with AP admitted to ourinstitution from October2010to April2012were included in this study. MRIwas performed for twice at least at the time of hospitalization, and the initialexams within48hour after admission. Initial and follow up MRIexaminations of gastrointestinal tract abnormalities were noted and werecompared by using the Chi Square Test or Fisher exact test. Pearsoncorrelation of the disappearance time of gastrointestinal tract abnormity inMRI with length of stay, the disappearance time of abdominal pain and so onwas analyzed.Results：70.97%of AP patients had at least one gastrointestinal tractabnormality in the initial exams within48h after admission and it wascorrelated with the MRSI and APACHE II score.25.81%of patients hadgastrointestinal tract abnormality in the follow up MRI examinations, whichwas significantly lower than that in the initial exams within48h afteradmission (P＜0.05). The time of gastrointestinal tract recovery in MRI wascorrelated with length of stay (r=0.825, P=0.000), the time of abdominal painrelease (r=0.831, P=0.000), recovery eating time (r=0.484, P=0.000) and timefor hematuria amylase recovery (r=0.325, P=0.010), but it had no correlatedwith anal exsufflation time(r=0.117, P=0.365)Conclusion: The gastrointestinal tract abnormality for patients with APon MRI soon returned to normal after treatment. The time of gastrointestinaltract recovery in MRI was positive correlated with length of stay, the time ofabdominal pain release and so on. MRI can be used as the objective indicatorfor monitoring treatment effects of gastrointestinal tract abnormity and maybean objective basis for clinical determine resumed the right time of recovery eating. |
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