Diagnosis of early-stage chronic pancreatitis by secretin-enhanced magnetic resonance cholangiopancreatography

2007 ◽  
Vol 42 (S17) ◽  
pp. 113-117 ◽  
Author(s):  
László Czakó
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Early Stage ◽  
Magnetic Resonance Cholangiopancreatography

scholarly journals Imaging of Fibrosis in Chronic Pancreatitis

2022 ◽  
Vol 12 ◽  
Author(s):  
Yasunobu Yamashita ◽  
Reiko Ashida ◽  
Masayuki Kitano
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Imaging Modalities ◽  
Diagnostic Tools ◽  
Diagnostic Modality ◽  
Magnetic Resonance Imaging Mri ◽  
Initial Imaging ◽  
Eus Elastography

Chronic pancreatitis (CP) describes long-standing inflammation of the pancreas, which leads to irreversible and progressive inflammation of the pancreas with fibrosis. CP also leads to abdominal pain, malnutrition, and permanent impairment of exocrine/endocrine functions. However, it is difficult to assess CP pathologically, and imaging modalities therefore play an important role in the diagnosis and assessment of CP. There are four modalities typically used to assess CP. Pancreatic duct features are assessed with magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). However, ERCP is a rather invasive diagnostic modality for CP, and can result in adverse events such as post-ERCP pancreatitis. Computed tomography (CT) is often the most appropriate initial imaging modality for patients with suspected CP, and has high diagnostic specificity. However, CT findings typically only appear in advanced stages of CP, and it is difficult to detect early CP. Endoscopic ultrasonography (EUS) provides superior spatial resolution compared with other imaging modalities such as CT and magnetic resonance imaging (MRI), and is considered the most reliable and efficient diagnostic modality for pancreatic diseases. The EUS-based Rosemont classification plays an important role in diagnosing CP in clinical practice. Evaluation of tissue stiffness can be another option to assess the diagnosis and progression of CP, and MRI and EUS can be used to assess CP not only with imaging, but also with elasticity measurement. MR and EUS elastography are expected to provide new alternative diagnostic tools for assessment of fibrosis in CP, which is difficult to evaluate pathologically.

scholarly journals Diagnostic value of research methods in diagnostics of chronic pancreatitis

2021 ◽  
Vol 102 (4) ◽  
pp. 528-536
Author(s):  
G R Aliyeva
Keyword(s):  
Chronic Pancreatitis ◽  
Early Stage ◽  
Imaging Modality ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Clinical History ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Invasive Approach ◽  
Pancreas Function ◽  
Function Testing

Chronic pancreatitis remains an unsolved problem for clinicians. One of the biggest dilemmas is to establish a clear diagnosis. Diagnosis can be particularly elusive in patients with early chronic pancreatitis. Many studies have been undertaken to improve diagnostics in chronic pancreatitis, but this has been significantly limited by the lack of a gold standard. The evaluation of patients with suspected chronic pancreatitis should follow a progressively non-invasive to more invasive approach. Computed tomography is the best primary imaging modality to obtain as it has good sensitivity for severe chronic pancreatitis and may exclude the need for other diagnostic tests. When ambiguous results are obtained, a magnetic resonance cholangiopancreatography may require for a more detailed evaluation of both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, endoscopic ultrasound with or without pancreas function testing becomes the preferred method. Endoscopic retrograde cholangiopancreatography remains a last line diagnostic test and generally should be used only for diagnostic purposes. Future researches in the field of diagnosis of early-stage chronic pancreatitis should purpose optimizing current diagnostic tools. A definitive diagnosis of chronic pancreatitis may not be made simply by clinical history, imaging or function testing alone, but rather by the data gathered by a combination of these diagnostic tools.

scholarly journals Anatomical Patterns of the Pancreatic Ductal System – A Cadaveric and Magnetic Resonance Cholangiopancreatography Study

2019 ◽  
Vol 36 (04) ◽  
pp. 279-285
Author(s):  
Mythraeyee Prasad ◽  
Sipra Rout ◽  
Tharani Putta ◽  
Reuben Thomas Kurien ◽  
Sudipta Dhar Chowdhury ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Pancreas Divisum ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Radiological Study ◽  
Ductal System ◽  
Type Iii ◽  
Ansa Pancreatica

Abstract Introduction Morphological variants of the pancreatobiliary system can predispose to chronic pancreatitis. The goal of the present study is to assess the prevalence of pancreatic duct patterns in the Indian population, both by cadaveric dissection and by magnetic resonance cholangiopancreatography (MRCP). Materials and Methods A total of 15 adult pancreas specimens of unknown age and gender, and 5 fetal pancreas specimens of different gestational ages with the intact second part of duodenum, were dissected by the piecemeal method. For clinical relevance, MRCP images of 103 clinically-diagnosed chronic pancreatitis patients irrespective of their etiology were obtained retrospectively from the existing database and studied. The anatomical patterns were classified as five different types based on the course of the main pancreatic duct and the accessory pancreatic duct and their openings into the duodenal wall, including variants like pancreas divisum and ansa pancreatica. Results In the cadaveric study, the main pancreatic duct was single with a straight course in 46.67% of the adult specimens, and in the MRCP study, the main pancreatic duct showed a descending course in 77.66% of the cases. The most common pattern was type III in both the cadaveric (80%) and radiological (55.33%) studies, and the accessory duct was absent on the MRCP in all type-III cases, while it ended blindly in the cadaveric specimens. Ansa pancreatica (type V) was observed in 1 adult specimen (6.7%), but not in the radiological study. Pancreas divisum (type IV) was observed in the 8 cases (7.76%) cases in the radiological study. Conclusion Knowledge of the anatomical variants of the pancreatic ductal system may be helpful for the radiologists during diagnostic and therapeutic interventional procedures.

Accuracy of Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography for the Diagnosis of Chronic Pancreatitis

2007 ◽  
Vol 41 (1) ◽  
pp. 88-93 ◽  
Author(s):  
Surakit Pungpapong ◽  
Michael B. Wallace ◽  
Timothy A. Woodward ◽  
Kyung W. Noh ◽  
Massimo Raimondo
Keyword(s):  
Chronic Pancreatitis ◽  
Magnetic Resonance ◽  
Endoscopic Ultrasonography ◽  
Magnetic Resonance Cholangiopancreatography
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