Advanced imaging of chronic pancreatitis.
Chronic pancreatitis is characterized by continuing inflammation, destruction, and irreversible morphological changes in the pancreatic parenchyma and ductal anatomy. These changes lead to chronic pain and/or loss of function. Although these definitions are simple, the clinical diagnosis of chronic pancreatitis remains difficult to make, especially for early disease. Routine imaging modalities such as transabdominal ultrasound and standard CT scans are insensitive for depicting early disease, and detect only advanced chronic pancreatitis. Advances in imaging modalities including CT, MRI with gadolinium contrast enhancement, MRI with magnetic resonance cholangiopancreatography (MRI/MRCP), MRI/MRCP with secretin-stimulation (S-MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS) allow earlier diagnosis of chronic pancreatitis. This article reviews the recognized findings, advantages, and disadvantages of the various imaging modalities in the management of chronic pancreatitis, specifically CT, MRI with or without MRCP and/or S-MRCP, ERCP, and EUS.
Choueiri
Nabil Elia
NE
Division of Gastroenterology and Hepatology, Saint Louis University Health Sciences Center, 3635 Vista Avenue at Grand Boulevard, Saint Louis, MO 63110, USA.
Balci
Numan Cem
NC
Alkaade
Samer
S
Burton
Frank R
FR
D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D002908:Chronic Disease; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D006801:Humans; D010195:Pancreatitis / Q000175:diagnosis*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*