Limitations of CT include relatively poor sensitivity for identifying ductal abnormalities, detecting subtle pancreatic parenchymal changes, and identifying noncalcified gallstones and choledocholithiasis. MRI Abdomen For meeting the imaging diagnostic criteria for AP, MRI abdomen without and with IV contrast with MRCP is at least equal and arguably superior to CT, particularly given the higher soft-tissue contrast resolution. Limitations of MRI include greater frequency of motion-related artifacts and a longer imaging time compared with that of CT. This is an important consideration in an acutely ill patient in whom the study may be degraded by large-volume ascites and breathing-related artifacts, especially in the presence of abdominal pain and pleural effusions. Benefits include good sensitivity even without the administration of an IV contrast agent (making it a useful alternative for patients with renal impairment or allergy to iodine-based CT contrast agents). Although MRI without IV contrast with MRCP provides information about the presence of biliary stones and fluid collections, pancreatic necrosis cannot be accurately assessed in the absence of IV contrast. Acute Pancreatitis The MRI findings of AP are typically an enlarged, edematous gland that is low signal on T1-weighted images and high signal on T2-weighted images. MRI can detect trace amounts of peripancreatic fluid, which is high signal on T2-weighted images and offers higher sensitivity than CT for the diagnosis of subtle, early changes of AP [17,18]. MRI is particularly well suited for pregnant women, patients with renal compromise, and younger patients with suspected AP, especially since studies have shown that patients who undergo early CT for AP are more likely to have repeat CT scans during the same admission [6,8].
Acute Pancreatitis. Limitations of CT include relatively poor sensitivity for identifying ductal abnormalities, detecting subtle pancreatic parenchymal changes, and identifying noncalcified gallstones and choledocholithiasis. MRI Abdomen For meeting the imaging diagnostic criteria for AP, MRI abdomen without and with IV contrast with MRCP is at least equal and arguably superior to CT, particularly given the higher soft-tissue contrast resolution. Limitations of MRI include greater frequency of motion-related artifacts and a longer imaging time compared with that of CT. This is an important consideration in an acutely ill patient in whom the study may be degraded by large-volume ascites and breathing-related artifacts, especially in the presence of abdominal pain and pleural effusions. Benefits include good sensitivity even without the administration of an IV contrast agent (making it a useful alternative for patients with renal impairment or allergy to iodine-based CT contrast agents). Although MRI without IV contrast with MRCP provides information about the presence of biliary stones and fluid collections, pancreatic necrosis cannot be accurately assessed in the absence of IV contrast. Acute Pancreatitis The MRI findings of AP are typically an enlarged, edematous gland that is low signal on T1-weighted images and high signal on T2-weighted images. MRI can detect trace amounts of peripancreatic fluid, which is high signal on T2-weighted images and offers higher sensitivity than CT for the diagnosis of subtle, early changes of AP [17,18]. MRI is particularly well suited for pregnant women, patients with renal compromise, and younger patients with suspected AP, especially since studies have shown that patients who undergo early CT for AP are more likely to have repeat CT scans during the same admission [6,8].