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Arablinskii A.V.1, Titov M.Yu.1,2, Buslavskaya A.1,2



Purpose. To study the capabilities of CT and MRI in identifying the characteristic features of the phase course of pancreatic necrosis.

Materials and methods. A retrospective analysis of CT and MRI studies was carried out, 64 patients of S.P. Botkin State Clinical Hospital in 2021 with a diagnosis of pancreonecrosis. The age range was 23-87 years. Primary CT scans of the abdominal cavity were performed immediately upon admission to the hospital, or after 3 days, if the diagnosis was established according to clinical and laboratory data. Follow-up CT examinations were performed every 7 days, or more often. All patients underwent CT scans, including the pancreatic phase. Abdominal MRI was performed to assess the structure of peripancreatic collections and their relationship with the main pancreatic duct.

Results. CT revealed areas of parenchymal necrosis in 80% of cases (sensitivity was 63% in the first 72 hours and 91% after 72 hours), collections in the structure of peripancreatic fiber in 100% of cases, additionally determined the localization and configuration of parenchymal necrosis, signs of encapsulation and infection of collections, as well as pathological changes in adjacent organs. In all cases, MRI made it possible to differentiate sequesters in the structure of peripancreatic collections (including in 75% of patients in whom they were not visible during CT) and their absence, and also determined the connection of collections with the main pancreatic duct (in 20% of studies), which was the basis for choosing a treatment method.

Discussion. Most patients with pancreatic necrosis have a severe course, therefore, accurate and timely characterization of changes on CT allows for timely initiation of intensive treatment. The use of specific generally accepted terminology is complicated by disagreements between domestic and international classifications.

Conclusion. CT is the gold standard for the diagnosis of acute pancreatitis, and its combination with MRI is able to characterize in detail the structure of changes in the pancreas, peripancreatic fiber, the main pancreatic duct, nearby organs and tissues.

1 - I.M. Sechenov First Moscow State Medical University (Sechenov University).

2 - S.P. Botkin City Clinical Hospital. Moscow, Russia.

Keywords: acute pancreatitis, necrotizing pancreatitis, diagnostics, phase, computed tomography, magnetic resonance imaging.


Corresponding author: Titov M.Yu., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript


For citation: Arablinskii A.V., Titov M.Yu., Buslavskaya A. CT and MRI in the diagnosis of the phase course of necrotizing pancreatitis. REJR 2022; 12(3):58-73. DOI: 10.21569/2222-7415-2022-12-3-58-73.

Received:        29.07.22 Accepted:       15.09.22