Diagnosis of pancreatic diseases is difficult due to late manifestations of symptoms, when the disease is already progressing. The MRI method( magnetic resonance imaging) is considered one of the most effective in diagnosing emergency conditions in pancreatology and in assessing the state of retroperitoneal lesions. The most informative method is MRI, conducted in parallel with MR-angiography and MR-cholangiopancreatography.
The method of MRI of the pancreas has its advantages:
- magnetic resonance imaging provides an optimal assessment of the state of the pancreas, its physiology in the system of the abdominal cavity;
- reveals pathologies that can not be diagnosed by other methods;
- optimally differentiates necrotic and fluid formations in the pancreas and in the retroperitoneal space;
- magnetic resonance imaging provides a more accurate visualization of the condition of the biliary and pancreatic tracts;
- detects stones in large and dilated ducts;
- efficiency in the diagnosis of the body and tail of the pancreas reaches 97%;The
- MRI method is safe for patients and specialists conducting the examination.
Indications for MRI of the pancreas
- Acute and chronic pancreatitis;
- Presence of stones in ducts;
- Shingles, stomach pain;
- Digestive disorders;
- Dysfunction of the intestine;
- Suspicion of neoplasm of gastrointestinal tract;
- Control of the postoperative condition of the patient with pancreatitis;
- Preparation for surgical intervention for acute pancreatitis.
Preparing for MRI of the pancreas
The procedure for magnetic resonance imaging of the pancreas is performed on devices with a magnetic field strength of more than 1.5 T.The patient is prescribed a sparing diet, excluding sharp, fried, fatty and salty dishes, as well as alcohol. Before conducting an MRI, you should not eat anything for 5-8 hours. For 30 minutes before the procedure begins, an allergic test is performed to the contrast agent administered intravenously. This substance, passing through the vessels, gives a visualization of all pathological processes in the pancreas and its ducts. The patient, having removed all metal objects and ornaments, is placed on the movable platform of the apparatus, which, after fixing it, rides into the internal space of the apparatus. The duration of the MRI lasts from 10 to 30 minutes. Decoding of the testimony takes place during the day.
CT of the pancreas with pancreatitis
The most sensitive method of visual examination today is the method of computed tomography. The principle of operation of the CT apparatus is the different density of organs and tissues, when x-rays are transmitted through them, with a layered image and visualization of their structure. X-rays give irradiation much lower than for radiography, and the informativeness of the method is much higher. This method is especially effective in the diagnosis of pancreatitis and other diseases. When CT is performed in acute pancreatitis, the pancreas is visualized with an indistinct contour, without a cellular structure characteristic of a normal, healthy pancreas. In this case, around the body, the exudative fluid and edema of the surrounding connective tissue are determined. Progressive destructive process leads to pancreatonecrosis.
In chronic pancreatitis, computed tomography reveals calcium deposits that can not be diagnosed by x-ray or other methods.
CT of the pancreas with contrasting
Contrast substances used in CT scan increase the diagnostic accuracy of the method. As contrast agents, water-soluble iodine-containing substances with infusomate( 100-120 ml intravenously drip in the calculation of 3-4 ml / sec) are used. The absence of a contrast agent in the structures of the pancreatic tissue indicates its necrotic lesion. Advantages of the method of computed tomography:
- high degree of spatial resolution;
- high speed survey;
- use of three-dimensional and multi-plane reconstruction of the images;
- a clear differentiation of necrotic masses from exudative formations, which is important when choosing further strategies and methods of treatment;
- the possibility of repeated use of computed tomography of the pancreas in order to visually assess the dynamics of the disease.
Before carrying out CT with contrast, the patient does not eat for several hours. Contraindications to the procedure are allergic reactions to iodine, kidney failure, severe diabetes mellitus, pregnancy, thyroid gland pathologies.
CT signs of pancreatitis
Based on the results obtained from computed tomography, it is possible to qualitatively assess the degree of organ damage, the degree of inflammation and necrotic process, abscesses and other pathologies. The severity of acute pancreatitis, recorded with CT, is used as prognostic signs:
- Degree A - normal pancreas;
- Degree B - signs of a slight increase in its dimensions;
- Degree C - signs of the process of inflammation of the pancreatic parenchyma;
- Degree D - signs of significant damage to the inflammatory process of the gland and the presence of exudate in the paranephric area;
These signs allow us to distinguish uncomplicated course of pancreatitis( A, B, C) and its severe forms( D and E) with a high percentage of deaths. In severe forms of pancreatitis complications arise in the form of abscesses and necrosis of pancreatic tissue.