Objective To investigate MRI features of pancreatic walled-off necrosis (WON) of acute necrotizing pancreatitis. Methods The clinical data of 56 patients (35 men, 21 women, mean age: 49.2±13.5 years) with first-onset acute pancreatitis and pathologically confirmed WON from January 2010 to June 2015 were retrospectively analyzed. The location, number, shape, size, edge, wall, contents, signal intensity and enhancement pattern of the WON lesions on MRI were recorded. Results The 81 WON lesions were solitary (37/81, 66.1%) or multiple (19/81, 33.9%) measuring 8.9±4.8 cm (range: 1.5-24.5 cm) in size with wall thickness of 3.6 ± 1.8 mm (range:2-12 mm). The lesions were located in peripancreatic(36/81,44.4%), peripancreatic and pancreatic (25/81, 30.9%) zones. Non-liquid contents without contrast enhancement can be identified in all pancreatic WONs with “bubble sign” and/or “gas-fluid level sign” in 21/56 (37.5%) on MRI. Conclusion Pancreatic WON is commonly seen in peripancreatic areas with MRI characteristic of complex contents.%目的：探讨急性坏死性胰腺炎的局部并发症胰腺包裹性坏死（WON）的MRI表现。方法回顾性分析从2010年1月～2015年6月间在我院住院的首发急性胰腺炎患者的临床资料，住院期间经外科病理证实为胰腺WON形成且术前有MRI检查者。在MRI工作站观察胰腺WON病灶的部位、数目、形态、大小、边缘、囊壁及内容物、信号及强化方式等。结果共计56例胰腺WON患者进入研究（男35例，女21例，年龄49．2±13．5岁），共发现WON病灶81个，单发者37例（66．1％）、多发者19例（33．9％）；病灶大小为8．9±4．8 cm（1．5～24．5 cm），WON位于胰周36个（44．4％）、胰周及胰内25个（30．9％）；WON囊壁厚度为3．6±1．8 mm（2～12 mm）。所有胰腺WON病灶内见非液性物质呈“破絮状、藕丝状、条带状碎片影”，且增强扫描未强化。 MRI和／或CT发现WON内气泡征、气－液平共21例（21／56，37．5％）。结论胰腺包裹性坏死最常见于胰腺外周，MRI能很好地显示胰腺WON的各种形态学特点，其中最具特征性的表现是胰腺WON内的复杂内容物成分。
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