Distúrbios Pancreáticos e Terapia
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Pancreatic Carcinoma with the First Symptom of Acute Pancreatitis: MRI Findings and Clinical Features

Zhang XM, Li Y, Ji YF, Bao ZG, Li XH, Chen TW, Huang XH and Yang L

Purpose: To study the MRI findings and clinical features of pancreatic carcinoma with the first symptom of acute pancreatitis.
Materials and Methods: Twelve patients with pancreatic carcinoma and the first symptom of acute pancreatitis were included in this study. Pancreatic carcinoma with acute pancreatitis was confirmed by pathology. The MRI findings and clinical features of pancreatic carcinoma combined with acute pancreatitis were noted.
Results: In the 12 patients with acute pancreatitis, the pancreas appeared edematous and non-necrotic on MRI. The pancreatic carcinomas were mainly located in the head of the pancreas (83.33%, 10/12). Most patients showed a mass on T1-weighted and T2-weighted images. A dilated pancreatic duct and/or Common Bile Duct (CBD) was observed on MRI of 75% (9/12) of the patients. The results of laboratory tests demonstrated increased CA19-9 in 8 of the patients (66.67%), elevation of both ALP and AST in 11 of the patients (91.67%), and normal ALP and AST levels in 1 patient.
Conclusions: Acute pancreatitis may be an indicator of pancreatic carcinoma. A pancreatic mass and a dilated pancreatic duct and/or CBD observed by MRI can provide evidence of the associated pancreatic carcinoma. Increased levels of ALT, AST or ALP and CA19-9 may aid the diagnosis of pancreatic carcinoma in cases of acute pancreatitis.