Purpose
The latest workstations with upgraded software for analysis CT data with MPR VR reconstruction allows to receive clear information about the localization of collections,
size of their extension,
their internal structure and interrelations with surrounding structures.
MSKT with intravenous bolus enhancement allows getting full information about the true sizes and the localizations of pancreatic necrosis.
(fig 1)
MRI is used as an addition to MDCT and allows to define the size and localization of seqestrums in collections.
We also can clearly differentiate the liquid and...
Methods and Materials
Our population
Review CT and MRI data of 250 patients which admitted in Botkinskaya Hospital from November 2007 to February 2011.
50 consecutive patients were excluded from study.
22 patients with combination of the acute pancreatitis and pancreas tumor.
9 patients with the pancreatitis after surgical on pancreas.
9 patients with the trauma of pancreas also were excluded.
For the assessment of suggested innovations during February – December 2011 we had been chosen patients whom surgical interventions were planned.
Patients were divided into two groups...
Results
Inflammation changes in retroperitoneal fat were obtained on CT and MRI images of all 200 patients.
In 122 cases forming the fluid collection were detected.
In 78 cases the retroperitoneal fat inflammation came to nothing more than infiltration.
To distinguish changes between fluid and infiltration we carried out the MRI (in 16 cases).
(fig 4)
As the prevalence of peripancreatic changes all the patients were divided into groups.
In group #1 were combined 80 patients with limited peripancreatic changes.
In 72 patients in this group...
Conclusion
The definition of the scope of the prevalence of peripancreatic changes can facilitate considerably the choice of a method of the treatment of the patient and therefore improve its results.
In case of problems visualization of the structure of the liquid in collectors MRI is a more detailed method,
supplementing the dynamic CT studies.
At the central type of the exudate spreading it more frequently appeared in the mesokolon transversum.
Mainly the location of the foci of necrosis under the pancreatic capsule illustrates that necrosis...
References
E.J.Balthazar,
A.J.Megibov,
R.
Pozzi Mucelli.
Imaging of the pancreas acute and chronic pancreatitis – Berlin Heidelberg: Spriger – Verlag,
2009 – 390p.
: il.
Marc G.
H.
Besselink,
Hjalmar C.
van Santvoort et all Describing Computed Tomography Findings in Acute Necrotizing Pancreatitis With the Atlanta Classification; An Interobserver Agreement Study; Pancreas - 2006;33:331-335
Marc G.
H.
Besselink,
HC van Santvoort,
TL Bollen,
MA Boermeester Management of patients with severe acute рancreatitis in the new millennium: prophylaxis,
nutrition,
imaging and intervention; Netherlands journal of critical care...