A diagnostic means of detecting chronic pancreatitis at an early stage, when the disease is still reversible, needs to be developed. Magnetic resonance cholangiopancreatography (MRCP) has recently been evolving as an important tool for the evaluation of chronic pancreatitis. In patients with moderate chronic pancreatitis, the pancreatic parenchyma displays an ...

BACKGROUND/AIM: Pancreatic juice (PJ) [IL-8] has been proposed as a marker for pancreatic diseases. We compared the accuracy of PJ [IL-8] and endoscopic ultrasound (EUS) to diagnose chronic pancreatitis (CP). METHODS: 79 patients with symptoms suspicious for CP were enrolled. PJ emptied into the duodenum was collected during an upper ...

Developments in magnetic resonance (MR) equipment and techniques have been remarkable. Especially, respiratory-triggered three-dimensional MR cholangiopancreatography (3D-MRCP) has been developed to provide images with high spatial resolution of the biliary tract and pancreatic duct. These 3D data can be employed in MR virtual endoscopy (MRVE) with volume rendering to visualize ...

A 69-year-old woman presented with obstructive jaundice and a 30-mm hypoechoic mass in the pancreatic head on ultrasonography. Magnetic resonance imaging (MRI) revealed enlargement of the pancreatic head with dilatation of the upstream main pancreatic duct and no dilatation of the proximal biliary tree. Endoscopic retrograde pancreatography showed a localized ...

Clonorchiasis is caused by a chronic infestation of liver flukes, Clonorchis sinensis, and these reside mainly in the medium- and small-sized intrahepatic bile ducts. Therefore, diffuse, uniform, minimal or mild dilatation of these bile ducts, particularly in the periphery, without dilatation of the extrahepatic bile duct is the typical finding ...

Pancreatic pseudocysts are common complications of pancreatitis. They may occur in unusual places as a result of spread along the path of least resistance. Penetration of Gerota's fascia and spread into the renal subcapsular space are uncommon. Their appearance on magnetic resonance imaging has not been previously documented. Given the ...

PURPOSE: To assess the usefulness of MRI and determine which MR sequence is most effective for diagnosing the mild forms of acute pancreatitis. MATERIALS AND METHODS: Forty subjects (20 normal volunteers and 20 patients with a mild form of acute pancreatitis) underwent MRI with fat-suppressed T1-weighted fast low-angle shot (FLASH), ...

Partial or complete agenesis of the dorsal pancreas is a rare congenital anomaly that results from the embryological failure of the dorsal pancreatic bud to form the body and tail of the pancreas. To date, four cases have been reported in Korea. We report an additional case; a 25-year-old woman ...

Major advances in endoscopic techniques to diagnose and manage pancreatic biliary diseases have fundamentally changed the approach to these difficult clinical challenges. The diagnosis of benign and malignant pancreatic-biliary diseases is much more readily obtained through a combination of cross-sectional imaging and endoscopic procedures. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ...

AIMS: To determine the sensitivity and complications of percutaneous biopsy of pancreatic masses, and whether typical computed tomography (CT) features of adenocarcinoma can reliably predict this diagnosis. MATERIALS AND METHODS: A 5 year retrospective analysis of percutaneous core biopsies of pancreatic masses and their CT features was undertaken. Data were ...

OBJECTIVE: The purpose of this article is to highlight the imaging features of congenital anomalies and normal variants of the pancreatic duct and the pancreas using contemporary imaging techniques such as MR cholangiopancreatography (MRCP), MRI, and helical CT. CONCLUSION: Congenital anomalies and normal variants of the pancreatic duct and the ...

Heterotopic pancreas is defined as the presence of pancreatic tissue at sites other than the pancreas. Involved sites may be the stomach, duodenum, proximal jejunum, ileum, congenital duodenal web, Meckel's diverticulum, ampulla of Vater, and the main pancreatic duct. We report the magnetic resonance cholangiopancreatography findings of a patient who ...

OBJECTIVE: The objective of our study was to evaluate the individual contributions of arterial, pancreatic parenchymal, and portal venous phase (PVP) images and the utility of coronal and sagittal multiplanar reformatted (MPR) images in the assessment of pancreatic adenocarcinoma using triple-phase MDCT. MATERIALS AND METHODS: Thirty-one patients with and 35 ...

OBJECTIVE: The purpose of this article is to highlight the imaging features of congenital anomalies and normal variants of the biliary tract with contemporary imaging techniques such as MR cholangiopancreatography (MRCP), MRI, and helical CT. CONCLUSION: Recognizing findings of congenital anomalies and normal variants of the biliary tract at MRCP, ...

We report on the case of a patient admitted for epigastric pain. An abdominal ultrasound revealed a voluminous cystic lesion of the left hepatic lobe. In magnetic resonance imaging, the mass had a liquid-liquid level that was spontaneously hyperintense on T(1)-weighted images and hypointense on T(2)-weighted images. Magnetic resonance cholangiography ...

OBJECTIVES: The 1992 Atlanta classification is a clinically based classification system that defines the severity and complications of acute pancreatitis. A study was undertaken to assess the interobserver agreement of categorizing peripancreatic collections on computed tomography (CT) using the Atlanta classification. METHODS: Preoperative contrast-enhanced CTs from 70 consecutive patients (49 ...

Magnetic resonance (MR) imaging with cholangiopancreatographic sequences plays a critical role in evaluating alterations in the biliary tract after surgical procedures such as cholecystectomy, liver transplantation, hepatic resection, and the creation of a biliary-enteric anastomosis. MR cholangiopancreatography, a rapid, noninvasive, and accurate imaging technique for the assessment of early and ...

OBJECTIVE: To describe computed tomography (CT) findings of invasive carcinoma derived from intraductal papillary mucinous neoplasms (IPMNs) of the pancreas during long-term follow-up. METHODS: Follow-up CT findings of 5 patients with IPMNs progressing to invasive carcinomas were respectively reviewed for 12 to 63 months. All patients underwent thin-section 3-phase helical ...

RATIONALE AND OBJECTIVES: The purpose of this study was to determine the relationship between the pancreatic enhancement on serial contrast-enhanced MRI (CEMRI) and pancreatic exocrine function using the secretin-stimulated endoscopic pancreatic function test (ePFT). MATERIALS AND METHODS: A total of 30 patients with clinical symptoms consistent with chronic pancreatitis underwent ...

The 3-dimensional image was excellent as a result of the fast scanning and narrow collimation using multidetector computed tomography (CT); and the parallel escalation in the capabilities of the workstation allow the use of CT angiography/CT cholangiography image fusion. We demonstrated the feasibility of fusion images of the hepatobiliary system. ...

We aimed to describe CT signs useful for differentiation of distal agenesis from distal or dorsal pancreas lipomatosis. Multidetector CT (MDCT) studies of five patients with distal pancreas agenesis (n = 2), distal lipomatosis (n = 1), distal short pancreas (n = 1), and distal pancreatectomy (n = 1) were ...

PURPOSE: A new generation of magnetic resonance imaging scanner offers a 3-dimensional magnetic resonance cholangiopancreatography (MRCP) with very high spatial resolution using a non-breath-hold technique with prospective navigator gating. The study aimed to investigate the new technology of the MRCP in infants with suspected pancreaticobiliary diseases. METHODS: Seven patients (4 ...

BACKGROUND/PURPOSE: Refluxes through pancreaticobiliary maljunctions play an important role in the pathophysiology of choledochal cysts. Dynamic studies of the pancreaticobiliary tract were performed using secretin-stimulated magnetic resonance cholangiopancreatography. METHODS: Six patients with choledochal dilation were recruited for this study. Four patients exhibited cystic and 2 exhibited fusiform dilatation of the ...

OBJECTIVE: CT is the established imaging technique for evaluation of pancreatic adenocarcinoma. MRI, however, can play a major role in this disease. The objective of this study is to illustrate the strengths of MRI for evaluating pancreatic adenocarcinoma. CONCLUSION: The superior soft-tissue contrast of MRI compared with CT is useful ...

This review discusses the current imaging modalities for the diagnosis and staging of solid and cystic pancreatic lesions and for the assessment of acute and chronic pancreatitis, and the future role of emerging technologies in the management of pancreatic diseases. Multidetector row spiral computed tomography is superior to conventional single-detector ...

OBJECTIVES: Pancreatic groove carcinoma usually presents with duodenal stenosis. This report describes the clinicopathologic features of 5 cases. METHODS: All the clinical and radiological features were reviewed retrospectively and analyzed to identify correlations with the histological findings. RESULTS: Vomiting was an initial symptom in all cases, but obstructive jaundice was ...

OBJECTIVE: Duodenal diverticulitis is a rare complication of duodenal diverticulosis. It is often clinically misdiagnosed because it has no pathognomonic signs or symptoms and its CT findings may mimic other intraabdominal processes. We describe two patients with duodenal diverticulitis who presented with abdominal pain, nausea, and leukocytosis. At the time ...

Congenital absence of the gallbladder is a rare, usually asymptomatic, anatomical variation. Some affected individuals may present with a clinical picture suggestive of gallbladder disease. This presentation, coupled with the inability of standard abdominal ultrasonography to convincingly diagnose agenesis of the gallbladder, can put the surgeon in a diagnostic and ...

Secretin-stimulated magnetic resonance cholangiopancreatography (MRCP) not only facilitate the depiction of anatomic variations or morphologic changes of the pancreatic duct in the normal and diseased pancreas but also help assessing functional abnormalities of the exocrine pancreas. In this article, we illustrate findings of normal pancreas and various pancreatic diseases on ...

In this paper, we report the usefulness of magnetic resonance cholangiopancreatography (MRCP) in excluding biliary atresia (BA) as the cause of neonatal cholestasis. MRCP with a 1.5-T magnetic resonance (MR) imaging unit was performed on four jaundiced neonates and infants aged from 38 days to 106 days. The diagnosis of ...

BACKGROUND: This study aimed to evaluate the accuracy of magnetic resonance cholangiography (MRC) in detecting variants of low cystic duct conjunction, which can be a source of confusion during surgery when unrecognized. METHODS: All cases with both MRC and endoscopic retrograde cholangiography (ERC) indicating suspected common bile duct stones between ...

Transabdominal ultrasonography is the first choice examination used for the etiological diagnosis of extrahepatic cholestasis because it is a noninvasive, rapid method and presently widely accessible. In this article we discuss the accuracy of transabdominal ultrasonography, computed tomography (CT), endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography ...

OBJECTIVE: The objective of our study was to assess the capabilities of MDCT for the diagnosis of an anomalous pancreaticobiliary ductal junction using high-resolution multiplanar reformatted (multiplanar reconstruction) images. MATERIALS AND METHODS: This study included nine patients with and 54 without an anomalous pancreaticobiliary ductal junction confirmed on direct cholangiopancreatography. ...

PURPOSE: To develop and evaluate an MR sialography protocol that reproducibly images the parotid and submandibular ducts over time, in 3D. Such a protocol is needed in order to investigate the possible radiation-induced changes to the salivary ducts in patients receiving radiotherapy to the head-and-neck. MATERIALS AND METHODS: MR sialography ...

Obstructing main pancreatic duct (PD) stones represent a challenge for endoscopic removal because they are frequently impacted within the duct, are hard, and process sharp edges. Multiple series have been published demonstrating that removal of obstructing stones in the main PD can improve symptoms in the majority of patients with ...

AIM: To evaluate the diagnostic performance of an interactive, adaptively averaged (AA) two-dimensional (2D) magnetic resonance cholangiography (MRC) technique in patients with suspected biliary disease by comparison to the standard MRC technique. MATERIALS AND METHODS: The AA 2D MRC method registers the images after acquisition, allowing summation of multiple images ...

We report a patient whose upper abdominal pain was due to an alcoholic pancreatic pseudocyst with hemorrhage. CT showed a gradually enhancing pancreatic pseudocyst about 6 cm in diameter. It exhibited hyposignal intensity on T2-weighted images and hypersignal intensity on T1-weighted images. Enlargement of the pancreatic pseudocyst was thought to ...

This prospective study compares repetitive thick-slab single-shot projection magnetic resonance cholangiopancreatography (MRCP) with endoscopic ultrasonography (EUS) for the detection of choledocholithiasis. Fifty-seven consecutive patients (36 women, mean age 61) referred for suspected choledocholithiasis underwent MRCP, followed by EUS. Each procedure was performed by different operators blinded to the results of ...

Although most insulinomas are small, they have been successfully detected by computed tomography and magnetic resonance imaging recently. However, preoperative localization of the insulinomas by arterial stimulation with venous sampling is crucial when they show atypical findings on these imaging modalities. We report a case of a large benign insulinoma ...

AIM: To review the computed tomography (CT), magnetic resonance imaging (MRI) and cholangiographic findings of chemotherapy-induced sclerosing cholangitis (CISC). METHODS: Between January 1995 and December 2004, 11 patients in the endoscopic retrograde cholangiography database were identified with CISC. Twelve CT, four MRI, 69 endoscopic and nine antegrade cholangiographic studies in ...

It is generally accepted that the surgical treatment of pancreatic necrosis should be delayed as long as possible and after there is laboratory confirmation of infection, determined by image guided fine-needle aspiration. Two cases of severe necrotizing pancreatitis are presented where gas developed in the pancreatic bed, detected by CT ...

OBJECTIVE: The objective of our study was to determine useful CT findings for differentiating cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis. MATERIALS AND METHODS: CT images of 30 patients with hepatolithiasis and pathologically proven cholangiocarcinoma (n = 14) or periductal fibrosis (n = 16) were retrospectively reviewed. Helical CT ...

BACKGROUND: Bile duct injury is one of the serious surgical complications of laparoscopic cholecystectomy (LC). Clear biliary tract imaging to detect the anomaly of the bile ducts before operation is thought to be useful to prevent this complication. The objective of this study was to investigate the preoperative feasibility of ...

A 54-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Upon physical examination the vital signs of the patient were within normal ranges. Ultrasonography and computed tomography (CT) examination of the abdomen was obtained, which demonstrated a large dilatated cystic structure, measuring approximately 68.6 ...

AIM: To evaluate the usefulness of various computed tomography (CT) findings including distribution of infiltration or fluid collection in differentiating the major etiologies of acute pancreatitis. METHODS: We reviewed 75 relatively severe cases of acute pancreatitis of alcoholic (n = 43) or biliary stone (n = 32) etiology having infiltration ...

Magnetic resonance (MR) imaging has considerable potential in characterizing pancreatic masses. Certain features can be used by the radiologist to establish a definitive diagnosis for most pancreatic tumors including ductal adenocarcinoma, islet cell tumors, solid and papillary epithelial neoplasms, micro- and macrocystic adenoma, and metastases. Recognition of these tumors on ...

BACKGROUND AND STUDY AIMS: Common bile duct (CBD) compression can be caused by stones in the cystic duct (Mirizzi syndrome) which can be difficult to diagnose even with endoscopic retrograde cholangiopancreatography (ERCP). Conventional imaging often gives insufficient information and endoscopic ultrasonography (EUS) and magnetic resonance imaging may improve diagnostic accuracy, ...

PURPOSE: To compare dynamic-contrast enhanced multirow detector computed tomography (MDCT) including multiplanar reformatted images (MPR) and magnetic resonance imaging (MRI) including magnetic resonance cholangiopancreatography images for the detection and assessment of locoregional extension of pancreatic adenocarcinoma. MATERIALS AND METHODS: Twenty-four patients with and 21 patients without pancreatic adenocarcinoma underwent triple-phase ...

BACKGROUND: Diagnosing pancreatic cancer by EUS-FNA is a potentially appealing alternative to percutaneous biopsy. AIM: To compare EUS-FNA with CT or US-guided FNA for diagnosing pancreatic cancer. DESIGN: Single center, prospective, randomized, cross-over. SETTING: Duke University Medical Center. POPULATION: Eighty-four patients referred with suspicious solid pancreatic mass lesions randomized to ...

AIM: To evaluate magnetic resonance cholangiopancreatography (MRCP) findings in conjunction with magnetic resonance (MR) images in autoimmune pancreatitis (AIP) patients. METHODS: Nine patients with AIP underwent MRI, MRCP, endoscopic retrograde cholangiopancreatography (ERCP), computed tomography, and ultrasonography. The MRCP and MR images taken before and after steroid therapy were reviewed and ...