Groove pancreatitis: MRI and pathologic findings.
OBJECTIVE
Our purpose is to describe the MRI findings with pathologic correlation, in five patients with groove pancreatitis, a specific form of chronic pancreatitis affecting the groove between the pancreatic head, the common bile duct and duodenum.


METHODS
Five patients with pathologically proven (four cases) and clinical and MRI findings (follow-up) consistent with the diagnosis of groove pancreatitis (one case) were reviewed. Three patients underwent cephalic pancreatoduodenectomy (Whipple procedure) due to severe duodenal stenosis; MRI findings were correlated with the histological findings.


RESULTS
In all patients a mass was seen affecting the groove between the pancreatic head and the duodenum. Precontrast images demonstrated hypointense tissue relative to pancreatic parenchyma on T1-weighted images and iso to slightly hyperintense tissue on STIR and T2-weighted images. Postcontrast dynamic Gd-DTPA images, showed peripheral mass enhancement on immediate postgadolinium images and progressive and centripetal mass enhancement on delayed images with good delineation of multiple cysts. Histologically, fibro-inflammatory tissue was demonstrated in the groove and the duodenal wall with obliterative concentric scarring of the distal common bile duct.


CONCLUSIONS
MRI findings are demonstrative of the pathologic features characteristic of this entity: the fibrous tissue in the pancreaticoduodenal groove, the duodenal wall inflammation and the groove and/or duodenal wall cyst formation.
Castell-Monsalve
F Javier
FJ
Department of Radiology, University Hospital Virgen del Rocio, Sevilla, Spain. jcastell@seram.org
Sousa-Martin
Jose M
JM
Carranza-Carranza
Andres
A
D000328:Adult; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000473:pathology* / Q000601:surgery
D003287:Contrast Media; D019786:Gadolinium DTPA