Chronic pancreatitis other imaging findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Other imaging findings
Other Imaging Findings
Other imaging findings may include:
MRCP:
- The diagnostic study of choice.
- Secretin-enhanced MRCP use has been increased recently for the early diagnosis of chronic pancreatitis.
- Findings suggestive of chronic pancreatitis may include:
- Calcifications
- Pancreatic duct obstruction
- It involves no radiation risk.
Endoscopic retrograde cholangiopancreatography (ERCP):
- ERCP is usually done when there is no evidence of
- Calcifications on imaging
- Steatorrhea
- Findings diagnostic of chronic pancreatitis may include
- Beaded appearance of the main pancreatic duct
- Ectatic side branches from the main pancreatic duct
- According to Cambridge classification, patients are divided into 3 categories on the basis of ductal changes seen on ERCP
| Cambridge classification | Ductal changes seen on ERCP |
|---|---|
| Cambridge I | Equivocal changes |
| Cambridge II | Mild to moderate changes |
| Cambridge III | Considerable changes |
Endoscopic ultrasonography:
Pancreatic function tests:
(a) Direct tests:
- Used to assess pancreatic insufficiency in the early course of disease when patient has clinical symptoms but no radiologic findings
- Secretin stimulation test is considered the gold standard functional test for diagnosis of chronic pancreatitis. The observation that bi-carbonate production is impaired early in chronic pancreatitis has led to the rationale of use of this test in early stages of disease.
(b) Indirect tests:
- Used to assess the complications of chronic pancreatitis
- Not sensitive to assess pancreatic insufficiency in the early course of disease
References
- ↑ 1.0 1.1 Ketwaroo G, Brown A, Young B, Kheraj R, Sawhney M, Mortele KJ, Najarian R, Tewani S, Dasilva D, Freedman S, Sheth S (2013). "Defining the accuracy of secretin pancreatic function testing in patients with suspected early chronic pancreatitis". Am. J. Gastroenterol. 108 (8): 1360–6. doi:10.1038/ajg.2013.148. PMC 5388854. PMID 23711627.