BACKGROUND & AIMS: It is uncertain whether computed tomography (CT) or endoscopic ultrasound (EUS) is superior for the detection, staging, and resectability of pancreatic cancer. We therefore performed a systematic literature review to determine which test is more accurate. METHODS: We identified relevant studies from MEDLINE (1986-2004) and evaluated study ...

Primary sclerosing cholangitis is a progressive cholestatic disease of unknown etiology leading to cirrhosis and liver failure. Several imaging modalities have been used to study this disease, including ultrasonography, computed tomography and hepatobiliary scintigraphy, but accurate diagnosis was found to be best made with endoscopic retrograde cholangiopancreatography or direct cholangiography. ...

Endoscopic retrograde cholangiopancreatography (ERCP) is well suited for the evaluation and treatment of diseases of the bile ducts and pancreas, but it carries the risk of inducing pancreatitis. Magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography have exceptional value in imaging the gallbladder, common hepatic duct, common bile duct, and pancreas. ...

Early diagnosis and accurate staging of carcinomas of the gallbladder and the bile ducts are helpful in improving the prognosis. Ultrasonography (US), a useful initial modality when exploring the background of jaundice or non-specific gastrointestinal complaints, sensitively reveals bile duct obstruction in particular. In unclear cases, or if US suggests ...

BACKGROUND: Solid-pseudopapillary tumor of the pancreas is a rather rare but low-grade malignant tumor with good prognosis after surgical excision. METHODS: In 3 patients with solid-pseudopapillary tumor of the pancreas which were proved pathologically, the imaging features (CT in all and MRI in one patient) of the tumor were analyzed. ...

Secretin causes temporary dilatation of pancreatic ducts, principally by increasing pancreatic exocrine secretions, and thus allows better visualization of the ducts at magnetic resonance (MR) cholangiopancreatography. Secretin-enhanced MR cholangiopancreatography is useful for detection and diagnosis of a variety of congenital, inflammatory, and neoplastic conditions of the pancreas. Although MR cholangiopancreatography ...

AIM: To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS: The pulse inversion technique (with intravenous injection of 2.4 mL SonoVue) or the power-Doppler mode under the conditions of the 2nd harmonic imaging (with intravenous injection of 4 g Levovist) was used for echo-enhanced ...

BACKGROUND: Optical coherence tomography has been proposed to obtain high-resolution imaging of tissue structure of GI tract. Up till now, the optical coherence tomography appearance of the common bile duct, main pancreatic duct and sphincter of Oddi wall structure has not yet been defined. AIMS: To compare, in a prospective ...

PURPOSE: The aim of this study was to compare magnetic resonance cholangiopancreatography (MRCP) using respiratory-triggered (resp) three-dimensional Fourier transformation (3D) fast-recovery fast spin echo (FR-FSE) sequence with array spatial sensitivity technique (ASSET) for visualization of the pancreatobiliary system with breath-hold single thick-section and multiple thin-section MRCP using 2D single shot ...

This study aimed to assess the ability of CT-i.v. cholangiography to show the perihilar biliary and cystic duct anatomy and to assess the relative performance of axial, maximum intensity projection and surface rendered displays. We also assessed the correlation between serum bilirubin levels and adequacy of biliary opacification. Spiral CT ...

BACKGROUND & AIMS: To evaluate the accuracy and interobserver variability of magnetic resonance cholangiography (MRC) and endoscopic retrograde cholangiography (ERC) in the diagnosis of primary sclerosing cholangitis (PSC). METHODS: MRC at 1.5 T with thin- and thick-slice breath-hold technique was performed in 66 adult patients (median age, 44 y; 26 ...

Only 20% of patients who present with pancreatic cancer will be amenable to potentially curative resection. Therefore, it is necessary to reliably identify patients who might benefit from major surgical intervention by employing the appropriate staging methods. In this review, the pros and cons of each imaging technique are discussed ...

The objective was the evaluation of minimum intensity projections (MinIP) of 16-channel multidetector computed tomography (MDCT) data for the visualization of biliary ducts with magnetic resonance cholangiopancreatography (MRCP) as reference method. Twenty-five patients with biliary obstruction who received MDCT of the abdomen and MRCP without subsequent interventions were analysed. Coronal ...

Insulinoma is a neuroendocrine tumour deriving mainly from the pancreatic islet cells that produces excessive amounts of insulin. Accurate preoperative detection and localization of insulinoma is essential for the selection of appropriate candidates for surgery. We present the case reports of three patients with benign pancreatic insulinoma. Preoperative assessment was ...

A case of a 24-year-old male with jaundice and epigastric pain is reported. The patient underwent a thorough clinical, laboratory, and imaging investigation. Computerized tomography revealed a 9 cm mult 10 cm choledochal cyst. Magnetic resonance imaging and magnetic cholangiopancreatography were performed, during which he developed an "acute abdomen", with ...

BACKGROUND: Drugs such as secretin and morphine have been used to augment the visualization of magnetic resonance cholangiopancreatography (MRCP). This study investigated the effectiveness of intravenous administration of a synthetic opioid, fentanyl, in improving the MRCP image quality. METHODS: Thirty consecutive patients with a provisional diagnosis of benign biliary and/or ...

Like biliary endoscopy, pancreatic endoscopic retrograde pancreatography (ERCP) has evolved from being a diagnostic procedure to a therapeutic one. The advent of magnetic resonance cholangiopancreatography and endoscopic ultrasonography have limited the need for anatomic definition and transpapillary tissue sampling, respectively. This review is therefore limited to studies published during the ...

OBJECTIVE: The management of pancreatic duct disruption is complex and depends on several factors including the cause, morphology, and degree of disruption. ERCP can show duct disruption in as many as 75% of patients but is invasive and cannot detect disruption beyond an obstruction. We studied the role of secretin ...

PURPOSE: To retrospectively compare accuracy of multi-detector row computed tomography (CT), combined with two-dimensional (2D) curved reformations, and that of magnetic resonance (MR) cholangiopancreatography (MRCP) for characterization of intraductal papillary mucinous neoplasm (IPMN) as malignant, with pathologic examination as reference standard. MATERIALS AND METHODS: Institutional review board approval was obtained, ...

This article presents current magnetic resonance imaging techniques for the diagnosis of acute and chronic pancreatitis and pancreatic neoplasms. It emphasises the need for a comprehensive protocol combining imaging sequences of the pancreatic parenchyma with magnetic resonance angiography and secretin-enhanced magnetic resonance cholangiopancreatography in order to evaluate the full range ...

Our study aimed to assess the diagnostic capabilities of mangafodipir trisodium-enhanced MRI for the evaluation of pancreatic disease. Sixty-three patients suspected of having pancreatic disease underwent MRI with a 1.5-T device. After the acquisition of axial and coronal T2-weighted sequences, the MR protocol included T1-weighted fat-suppressed breath-hold SPGR images obtained ...

CONTEXT: Although there exists multiple modalities of managing traumatic pancreatic pseudocysts it remains a diagnostic and therapeutic challenge. We report herein a case that was successfully managed by endoscopic ultrasound guided transgastric stent placement. CASE REPORT: A 28-year-old female jockey presented with abdominal pain after being kicked by a horse. ...

We report a rare case of porcelain gallbladder associated with pancreas divisum (PD). A 60-year-old woman suffered from discomfort in the back of the right side. An abdominal radiograph revealed a calcified spherical mass in the right upper quadrant. Ultrasonography revealed a scattered echo with a posterior acoustic shadow in ...

Autoimmune pancreatitis (AIP) is a new clinical entity recently described. Histologically it consists of a lymphoplasmacytic infiltration with diffuse fibrosis. Pancreatic imaging on US, CT and ERCP shows diffuse enlargement of the pancreatic gland and an irregular narrowing of the pancreatic duct. Hypergammaglobulinemia, increased serum levels of total IgG or ...

The ability to diagnose pancreatic carcinoma has been rapidly improving with the recent advances in diagnostic techniques such as contrast-enhanced Doppler ultrasound (US), helical computed tomography (CT), enhanced magnetic resonance imaging (MRI), and endoscopic US (EUS). Each technique has advantages and limitations, making the selection of the proper diagnostic technique, ...

The most important issues in pancreatic imaging are the detection and staging of pancreatic cancer, differentiation between cancer and focal pancreatitis, the characterization of cystic lesions and the search for neuroendocrine tumours. Magnetic resonance (MR) units (1.5 T) with strong gradients and a phased-array torso coil should be used, making ...

INTRODUCTION: Bile leak after liver injury has been reported to be a complication associated with significant mortality. Tc99m-IDA (Tc: Technetium) nuclear scan allows rapid and noninvasive diagnosis of bile leak. OBJECTIVE: An accidental case was referred for the detection of suspicious bile leak. METHODS: The ultrasound could not detect any ...

The clinical and histochemical examination of hormone-producing serous cystadenomas of the pancreas are presented. The study material was obtained from five female patients. The patients underwent diagnostic examinations, including ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI) and Doppler ultrasonography examination of abdomen. In all cases the presence of serous ...

Annular pancreas is an uncommon congenital anomaly associated with duodenal atresia in neonates. Rarely, the condition may manifest later in life. These symptoms include abdominal pain, nausea, and vomiting and usually arise due to obstruction to gastric emptying. Abdominal CT scan with high resolution and angiography protocol and magnetic resonance ...

OBJECTIVE: Our objective was to determine whether MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis in the initial phase of the disease. One hundred six patients with abdominal pain were prospectively enrolled in this study. CONCLUSION: Patients were separated into two groups: P1 (severe) and ...

BACKGROUND: Magnetic resonance cholangiopancreatography (MRCP) is an alternative to diagnostic endoscopic retrograde cholangiopancreatography (ERCP) for investigating biliary obstruction. The use of MRCP, a non-invasive procedure, may prevent the use of unnecessary invasive procedures. The aim of the study was to compare the findings of MRCP with those of ERCP by ...

The currently used diagnostic criteria for acute pancreatitis in Japan are presentation with at least two of the following three manifestations: (1) acute abdominal pain and tenderness in the upper abdomen; (2) elevated levels of pancreatic enzyme in the blood, urine, or ascitic fluid; and (3) abnormal imaging findings in ...

BACKGROUND: Autoimmune pancreatitis is a new clinical entity that is characterized by peculiar histopathologic and laboratory findings and by a dramatic clinical response to corticosteroid therapy. We evaluated the radiologic findings of autoimmune pancreatitis. METHODS: Computed tomographic, magnetic resonance imaging, endoscopic retrograde cholangiopancreatographic, and ultrasonographic findings of 20 patients with ...

Branch duct intraductal papillary mucinous tumors (IPMTs) are increasingly being described and represent a challenge for the physician. Recent imaging modalities, especially computed tomography and magnetic resonance, allow for a correct diagnosis, but IPMTs can manifest with different degrees of cellular atypia so it is very important to be able ...

BACKGROUND: We sought to validate computed tomographic virtual pancreatoscopy (CT-VP) created by multidetector row CT (MD-CT) in the clinical diagnosis of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. METHODS: Five cases of pancreatic IPMNs were included in this study. A nasopancreatic drainage tube was inserted and the pancreatic duct ...

We compared the diagnostic accuracy of multidetector-row computed tomography (MDCT) with multiplanar reconstruction (MPR) images to non-contrast magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) (MRI/MRCP) for evaluating obstructive jaundice. MDCT and MRI/MRCP images from 53 patients with suspected obstructive jaundice were interpreted by two radiologists. These readers evaluated ...

Because of the increasing frequency of surgical procedures such as hepatic resection, partial liver transplantation, and laparoscopic cholecystectomy, the number of patients requiring biliary imaging has increased. In this report, magnetic resonance cholangiopancreatography findings of a case with an aberrant right posterior hepatic duct draining directly into the gallbladder, which ...

The purpose of this study was to evaluate the diagnostic potential of prolonged drip infusion CT cholangiography (DIC-CT) using meglumine iotroxate (Biliscopin) and 3D volume rendering in patients with suspected obstructive biliary disease. From a material of 142 patients who had undergone a drip infusion CT, all cases with a ...

PURPOSE: To present MR cholangiopancreatography (MRCP) findings and to determine the hepatic morphological changes of primary sclerosing cholangitis (PSC) seen on T2-weighted fast spin echo (FSE) images. MATERIALS AND METHODS: Twenty-three patients (15 women, 8 men) with ages ranging from 17 to 80 years (median, 45.1 years) were included in ...

The study was conducted, with institutional review board approval and informed patient consent, to assess the feasibility and diagnostic effectiveness of three-dimensional direct multi-detector row computed tomographic (CT) cholangiography for determining the extent of bile duct invasion by hilar cholangiocarcinoma. Eleven patients underwent contrast material-enhanced direct multi-detector row CT cholangiography ...

OBJECTIVE: To evaluate the usefulness of serum biochemical variables and scintigraphic study results for differentiating between dogs and cats with complete extrahepatic biliary obstruction (EHO) and those with partial EHO or patent bile ducts. STUDY DESIGN: Retrospective case series. ANIMALS: 17 dogs and 1 cat. PROCEDURE: Animals that underwent hepatobiliary ...

We have developed genetically fluorescent orthotopic models of human pancreatic cancer. In these models, noninvasive fluorescent protein imaging (FPI) of internal primary tumors and metastatic deposits has been carried out. Whole-body tumor images are easily and inexpensively obtained using FPI, permitting both detection and quantification of tumor load. In this ...

AIM: To evaluate the imaging findings of biliary hamartomas (von Meyenburg complexes, VMCs) and discuss the differential diagnosis with other related diseases. METHODS: Imaging findings of biliary hamartomas on ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), MR cholangiopancreatography (MRCP)and hepatobiliary scintigraphy were retrospectively analyzed in six patients. RESULTS: ...

MR imaging is establishing a role as a primary diagnostic technique, with increasing evidence showing MR imaging to have advantages over CT regarding diagnostic sensitivity and specificity for many pathologies of solid organs, bile and pancreatic ducts, bowel, peritoneum, and retroperitoneum. In addition, there are increasing concerns regarding the risks ...

We wondered whether nonenhanced computed tomography (CT) within 48 hours of admission could identify individuals at risk for higher mortality from acute pancreatitis. Data from the international phase III study of the platelet-activating factor-inhibitor Lexipafant was used to analyze noncontrast CT versus acute pancreatitis mortality. Nonenhanced CT examinations of the ...

Subcutaneous manifestations (Grey Turner's sign and Cullen's sign) of severe acute pancreatitis (SAP) are often discussed but rarely observed in a daily clinic setting. This paper will demonstrate the anatomic pathways followed by the extravasated pancreatic enzymes and how their effects lead to these ecchymoses by multiplanar reformation (MPR) images ...

The authors have developed a CT protocol, CT duodeno-cholangiopancreatography (CDCP), which is performed during a single contrast-enhanced phase, proceeding cranially, allowing enhancement of the pancreas during its parenchymal phase followed by enhancement of the liver during its portal-venous phase. This retrospective pilot study evaluates CDCP compared with endoscopic retrograde cholangiopancreatography ...

PURPOSE OF REVIEW: Exciting new developments and applications of imaging techniques in pancreatic diseases have emerged. This review discusses these new advances and how they are improving our ability to diagnose malignancies and inflammatory lesions, to grade severity of pancreatitis, and to stage pancreatic cancer accurately. RECENT FINDINGS: A new ...

OBJECTIVE: To re-assess the value of CT and clinical criteria as prognostic and severity indicators in acute pancreatitis and the correlation between them. METHODS: Sixty-five cases with acute pancreatitis (AP) were included in the study. The hospitalization days, fevering days and overall complications were regarded as clinical endpoints for the ...

PURPOSE: There has been one report that tissue blood flow (TBF) quantification with xenon CT was effective in predicting the therapeutic response to an anticancer drug in pancreatic cancer. The purpose of this study was to evaluate the correlation between the TBF of pancreatic tumors calculated with xenon CT and ...