Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study
Background/Aims: The development of infection in pancreatitis increases the mortality rate up to 32%. Therefore, it is important to identify patients who are at high risk of developing infection, at an early stage. The objectives of the study were (a) to analyze the quantitative parameters of diffus...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | The Saudi Journal of Gastroenterology |
| Subjects: | |
| Online Access: | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2020;volume=26;issue=1;spage=20;epage=25;aulast=Sureka |
| _version_ | 1818061684940472320 |
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| author | Binit Sureka Balwant Rai Vaibhav Varshney Vijaya L Nag Mahendra K Garg Pawan K Garg Taruna Yadav Pushpinder S Khera Akhil Goel |
| author_facet | Binit Sureka Balwant Rai Vaibhav Varshney Vijaya L Nag Mahendra K Garg Pawan K Garg Taruna Yadav Pushpinder S Khera Akhil Goel |
| author_sort | Binit Sureka |
| collection | DOAJ |
| description | Background/Aims: The development of infection in pancreatitis increases the mortality rate up to 32%. Therefore, it is important to identify patients who are at high risk of developing infection, at an early stage. The objectives of the study were (a) to analyze the quantitative parameters of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) in infected as well as sterile pancreatic collections (b) to establish “cut-off” values for ADC that can identify infected pancreatic collections.
Materials and Methods: Prospective observational study of pancreatitis cases who underwent DW-MRI from August 2018 to July 2019 were enrolled in the study. The collections were analyzed for diffusion restriction. The average of the three ADC values from the wall and center of collection was noted.
Results: Infected collections were seen in 7 and sterile collections observed in 11 cases. The optimal cut-off ADC value to differentiate sterile and infected collection in our study was 1.651 × 10-3 mm2/s (sensitivity of 81.8%; specificity of 100.0%). ROC curve for mean ADC from the wall showed a significant diagnostic accuracy with AUC: 0.91; 95% CI: 0.77-1.0 (P = 0.004).
Conclusion: DW-MRI is a reliable noninvasive technique to differentiate sterile and infected pancreatic collections. ADC values from the periphery of the collection can predict infected pancreatic collections at an early stage. DW-MRI should not be considered as a substitute for aspiration cytology in patients with septic symptoms and absent diffusion restriction on MRI. |
| first_indexed | 2024-12-10T13:52:14Z |
| format | Article |
| id | doaj.art-9449a8788d9b476e8a769f42fb5c9887 |
| institution | Directory Open Access Journal |
| issn | 1319-3767 1998-4049 |
| language | English |
| last_indexed | 2024-12-10T13:52:14Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | The Saudi Journal of Gastroenterology |
| spelling | doaj.art-9449a8788d9b476e8a769f42fb5c98872022-12-22T01:46:09ZengWolters Kluwer Medknow PublicationsThe Saudi Journal of Gastroenterology1319-37671998-40492020-01-01261202510.4103/sjg.SJG_411_19Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot studyBinit SurekaBalwant RaiVaibhav VarshneyVijaya L NagMahendra K GargPawan K GargTaruna YadavPushpinder S KheraAkhil GoelBackground/Aims: The development of infection in pancreatitis increases the mortality rate up to 32%. Therefore, it is important to identify patients who are at high risk of developing infection, at an early stage. The objectives of the study were (a) to analyze the quantitative parameters of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) in infected as well as sterile pancreatic collections (b) to establish “cut-off” values for ADC that can identify infected pancreatic collections. Materials and Methods: Prospective observational study of pancreatitis cases who underwent DW-MRI from August 2018 to July 2019 were enrolled in the study. The collections were analyzed for diffusion restriction. The average of the three ADC values from the wall and center of collection was noted. Results: Infected collections were seen in 7 and sterile collections observed in 11 cases. The optimal cut-off ADC value to differentiate sterile and infected collection in our study was 1.651 × 10-3 mm2/s (sensitivity of 81.8%; specificity of 100.0%). ROC curve for mean ADC from the wall showed a significant diagnostic accuracy with AUC: 0.91; 95% CI: 0.77-1.0 (P = 0.004). Conclusion: DW-MRI is a reliable noninvasive technique to differentiate sterile and infected pancreatic collections. ADC values from the periphery of the collection can predict infected pancreatic collections at an early stage. DW-MRI should not be considered as a substitute for aspiration cytology in patients with septic symptoms and absent diffusion restriction on MRI.http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2020;volume=26;issue=1;spage=20;epage=25;aulast=Surekaapparent diffusion coefficientdiffusion mriinfectedpancreatic collectionssterile |
| spellingShingle | Binit Sureka Balwant Rai Vaibhav Varshney Vijaya L Nag Mahendra K Garg Pawan K Garg Taruna Yadav Pushpinder S Khera Akhil Goel Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study The Saudi Journal of Gastroenterology apparent diffusion coefficient diffusion mri infected pancreatic collections sterile |
| title | Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study |
| title_full | Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study |
| title_fullStr | Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study |
| title_full_unstemmed | Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study |
| title_short | Quantitative diffusion-weighted magnetic resonance imaging for prediction of early infection in pancreatic collections: Results of a pilot study |
| title_sort | quantitative diffusion weighted magnetic resonance imaging for prediction of early infection in pancreatic collections results of a pilot study |
| topic | apparent diffusion coefficient diffusion mri infected pancreatic collections sterile |
| url | http://www.saudijgastro.com/article.asp?issn=1319-3767;year=2020;volume=26;issue=1;spage=20;epage=25;aulast=Sureka |
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