title: Pancreatic duct abnormalities in focal autoimmune pancreatitis: MR/MRCP imaging findings.
abstract: OBJECTIVE
  To evaluate the magnetic resonance (MR) imaging-MR cholangiopancreatographic (MRCP) findings of focal forms of autoimmune pancreatitis (AIP) to describe ductal involvement at diagnosis.
  
  
  METHODS
  MR examinations of 123 patients affected by AIP were analysed. We included 26 patients who satisfied International Consensus Diagnostic Criteria and were suffering from focal AIP. Image analysis included: site of parenchymal enlargement, main pancreatic duct (MPD) diameter, MPD stenosis, stricture length, presence of upstream dilation within the stricture, signal intensity, and pancreatic enhancement.
  
  
  RESULTS
  Signal intensity abnormalities were localized in the head in 10/26 (38.5%) and in the body-tail in 16/26 (61.5%) patients. MRCP showed a single MPD stenosis in 12/26 (46.1%) and multiple MPD stenosis in 14/26 (53.8%) patients, without a dilation of the upstream MPD (mean: 3.83 mm). Lesions showed hypointensity on T1-weighted images in all patients, and hyperintensity on T2-weighted images in 22/26 (84.6%) patients. The affected parenchyma was hypovascular during the arterial phase in 25/26 (96.2%) patients with contrast retention.
  
  
  CONCLUSIONS
  MR-MRCP are effective techniques for the diagnosis of AIP showing the loss of the physiological lobulation and the typical contrastographic appearance. The presence of multiple, long stenoses without an upstream MPD dilation at MRCP suggests the diagnosis of AIP, and can be useful in differential diagnosis of pancreatic adenocarcinoma.
  
  
  CONCLUSIONS
  • MRI represents the gold standard in the diagnosis of AIP. • MRCP is an increasingly useful technique in the diagnosis of focal AIP. • MRCP could be a problem-solving tool in the differential diagnosis of AIP.
authors.affiliation: Department of Radiology, G.B. Rossi University Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy, ricky.negrelli@gmail.com.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Negrelli
authors.forename: Riccardo
authors.initials: R
authors.lastname: Manfredi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pedrinolla
authors.forename: Enrico
authors.initials: E
authors.lastname: Boninsegna
authors.forename: Anna
authors.initials: A
authors.lastname: Ventriglia
authors.forename: Sara
authors.initials: S
authors.lastname: Mehrabi
authors.forename: Luca
authors.initials: L
authors.lastname: Frulloni
authors.forename: Roberto
authors.initials: R
authors.lastname: Pozzi Mucelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000473:pathology*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods; D003251:Constriction, Pathologic / Q000473:pathology; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology; D010195:Pancreatitis / Q000473:pathology*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media
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