What question did this study set out to answer?

The aim is to evaluate the effectiveness of diffusion-weighted MRI in diagnosing and staging acute pancreatitis per the revised Atlanta classification.

February 2, 2026Open Access

Utility of Diffusion Weighted Magnetic Resonance Imaging in Early Detection and Staging of Acute Pancreatitis: Correlation with Revised Atlanta Classification

Key Points

The aim is to evaluate the effectiveness of diffusion-weighted MRI in diagnosing and staging acute pancreatitis per the revised Atlanta classification.
Conducted a prospective assessment with 34 patients diagnosed with acute pancreatitis.
Measured apparent diffusion coefficient (ADC) values using diffusion-weighted MRI.
Analyzed correlation between ADC values and severity of pancreatitis according to the revised Atlanta classification.
Mean ADC values across different severity levels of pancreatitis were identified, with significant differences between normal and acute pancreatitis cases.
ROC analysis demonstrated high accuracy in differentiating severe from non-severe pancreatitis with AUC values of 0.827 and 0.870 respectively.
All mild acute pancreatitis cases showed true diffusion restriction, while 80% of necrotizing pancreatitis cases displayed facilitated diffusion.

Abstract

Background: Acute pancreatitis (AP) is associated with a high mortality rate that is directly related to its severity. Limited research has been conducted on the role of DWI-MRI in the diagnosis and staging of acute pancreatitis as it pertains to the revised Atlanta classification. The objective of this study was to examine the role of diffusion-weighted (DW) magnetic resonance imaging (MRI) in early diagnosis and staging of acute pancreatitis in correlation to the revised Atlanta classification. Methods: According to the revised Atlanta classification, a prospective assessment was performed to examine the correlation between DW MRI and apparent diffusion coefficient (ADC) values with the severity of acute pancreatitis (AP) in a sample of 34 patients diagnosed with AP. Results: The mean ADC value of mild edematous pancreatitis was 1.14±0.06x10-3 mm2/sec, moderate edematous pancreatitis was 1.18±0.16x10-3 mm2/sec, severe necrotizing pancreatitis was 1.99±0.06x10-3 mm2/sec, and that of the normal pancreas was 1.54±0.05 x10-3 mm2/sec. Based on the revised Atlanta classification, there was a significant difference between the ADC values of normal pancreas and acute, severe, and mild/moderate pancreatitis, while there was no significant difference between mild and moderate pancreatitis cases. ROC analysis yielded high accuracy in differentiating normal pancreas from acute pancreatitis and severe pancreatitis from non-severe pancreatitis (AUC=0.827 and 0.870, respectively). Discussion: In the current study, the qualitative assessment of DWI images indicated that all cases of mild acute pancreatitis (AP) displayed true diffusion restriction, while facilitated diffusion was observed in 80% of patients diagnosed with necrotizing pancreatitis. Our findings have validated the outcomes of earlier research regarding the average ADC values of both the healthy and acutely inflamed pancreas. According to the Revised Atlanta Classification, DWI has the ability to assist in the prompt diagnosis of acute pancreatitis and to differentiate mild forms from severe ones. Conclusion: DW-MRI using both qualitative and quantitative methods provides a concise, safe, and radiation-free imaging method for early detection and assessing the severity of acute pancreatitis.

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