Case of the Week: Necrotizing Pancreatitis (CT & MRI)
In this radiology lecture, we discuss the imaging appearance of necrotizing pancreatitis on both CT and MRI.
Key points include:
- According to the revised Atlanta classification, there are two types of acute pancreatitis: Interstitial edematous pancreatitis (IEP) and necrotizing pancreatitis (NP).
- For IEP, fluid collection in first 4 weeks = acute peripancreatic fluid collection, after 4 weeks = pseudocyst.
- For NP, fluid collection in first 4 weeks = acute necrotic collection, after 4 weeks = walled-off necrosis.
- Non-enhancing hypoattenuating areas = necrotizing pancreatitis.
- Gas suspicious for infection/emphysematous pancreatitis.
- Vascular complications are important to identify.
- Venous thrombosis: splenic, portal, and mesenteric veins.
- Pseudoaneurysms: Splenic and gastroduodenal artery.
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