Magnetic resonance imaging in patients with pancreatitis: Evaluation of signal intensity and enhancement changes

Purpose To evaluate the utility of unenhanced and enhanced T1-weighted fat-suppressed (T1-FS) magnetic resonance imaging (MRI) in detecting pancreatitis. Materials and Methods 1.5-T MRI was performed in 25 patients with acute and 23 patients with chronic pancreatitis and in 20 control subjects without known pancreatic disease. T1-FS spin-echo and contrast-enhanced arterial-predominant (DYN1) and portal-predominant (DYN2) fast multiplanar spoiled gradient-echo (FMPSPGR) sequences were evaluated. These three sets of images were evaluated both subjectively for decreased or heterogeneous signal intensity (rating scale, 0–3) and objectively (region of interest (ROI)) in the head, body, and tail of the pancreas, in each patient. Results Good correlation between subjective assessment and objective data was demonstrated. The T1-FS sequence showed an abnormality with greater frequency (T1-FS > DYN1, 81/144 scores; T1-FS = DYN1, 63/144 scores; T1-FS < DYN1, 0/144 scores) and magnitude (average subjective score, 2.48 vs. 1.74; P < 0.0003) than that of the contrast-enhanced FMPSPGR (decreased or heterogeneous enhancement). The overall sensitivity and specificity of MRI was 92% and 50%, respectively. On the basis of signal intensity and enhancement, MRI was not able to differentiate acute from chronic pancreatitis. Conclusion MRI was highly sensitive for disease detection, particularly using the T1-FS sequence, but using the sequences described, was not able to differentiate acute from chronic pancreatitis. J. Magn. Reson. Imaging 2002;15:275–284. © 2002 Wiley-Liss, Inc.