The characteristics of acute necrotizing pancreatitis in different age stages: An MRI study. Issue 122 (January 2020)

• Record Type: Journal Article
• Authors: Yang, Dan Dan; Zuo, Hou Dong; Wu, Chang Qiang; Chen, Tian Wu; Xue, Hua Dan; Jin, Zheng Yu; Zhang, Xiao Ming
• Is Part Of: European journal of radiology. Issue 122(2020)
• Publication Date: 2020-01
• Subjects: AP acute pancreatitis -- SAP severe acute pancreatitis -- ANP acute necrotizing pancreatitis -- CT computed tomography -- MRI magnetic resonance imaging -- RAC revised atlanta classification -- EPN extrapancreatic necrosis -- PN pancreatic necrosis -- OF organ failure -- POF persistent organ failure -- MOF multiple organ failure -- CECT contrasted enhanced CT; Magnetic resonance imaging -- Acute necrotizing pancreatitis -- Necrosis -- Age factor; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2019.108752
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: Age is a factor of special concern in term of characteristics of ANP. Elderly patients are more likely to suffer ANP, combined necrosis and extensive EPN. PN alone is more common in young patients. Combined necrosis, extensive EPN and >30 % PN have more severe clinical outcomes. Abstract: Purpose: To study the characteristics of acute necrotizing pancreatitis (ANP) in different age stages and their correlations with the clinical outcomes using magnetic resonance imaging (MRI). Method: MRI of 716 patients with acute pancreatitis was retrospectively reviewed to assess the incidence and characteristics of ANP. On MRI, ANP was classified into three subtypes: extrapancreatic necrosis (EPN) alone, pancreatic necrosis (PN) alone and combined necrosis. The extent of necrosis was also quantified on MRI. All patients were divided into three age groups, that is, young, middle-aged and elderly groups, and these characteristics of ANP were compared among the three age groups. The endpoints of patients' clinical outcome were compared among different age groups and different characteristics of ANP. Results: Of the 716 patients, 129(18 %) were identified as ANP on MRI. The prevalence of ANP in the elderly group was the highest (28.9 %, p < 0.05). The patients in the middle-age and the elderly groups exhibited a higher risk of combined necrosis (56.9 %, 55.8 %; respectively), and elderly patients more frequently had extensive extrapancreatic involvement compared with young patients (65.9 % vs 21.4 %; p = 0.004); however, PN alone was more common in young patients. These characteristics of ANP were significantly bound up with clinical outcomes. Conclusions: Different subtypes of ANP have different outcomes. More importantly, age needs to be considered as a factor of special concern in development of ANP.