High signal peripancreatic fat on fat-suppressed spoiled gradient echo imaging in acute pancreatitis: Preliminary evaluation of the prognostic significance

Abstract

Purpose: To evaluate peripancreatic signal changes on fat-suppressed T1-weighted spoiled gradient echo images associated with acute pancreatitis and investigate potential utility in regards to relationship to clinical outcome. Materials and Methods: The abdominal MR images in 31 patients with acute pancreatitis were reviewed, and evaluated for the presence of elevated signal intensity within the peripancreatic fat on fat-suppressed T1-weighted spoiled gradient echo images; the degree of signal changes was graded as mild, moderate, or severe. Results: Ten of 31 patients demonstrated abnormal high signal intensity in the peripancreatic fat on fat-suppressed T1-weighted images. The degree of signal change was mild in three patients, moderate in one, and severe in six patients. All six patients with severe elevated peripancreatic soft tissue signal died within seven to 68 days (mean, 47 days) of their admission. All 21 patients without elevated peripancreatic fat signal survived without any complications. The correlation between the presence and severity of elevated peripancreatic MR signal and patient outcome was significant (P < 0.05). Conclusion: Elevated peripancreatic signal on fat-suppressed T1-weighted images is associated progressively with poor outcome in patients with acute pancreatitis, and may represent a simplified method for prognostic cross-sectional imaging. © 2003 Wiley-Liss, Inc.