Autoimmune Pancreatitis: Pancreatic and Extrapancreatic MR Imaging–MR Cholangiopancreatography Findings at Diagnosis, after Steroid Therapy, and at Recurrence

Abstract

MR imaging with MR cholangiopancreatography enables the diagnosis of pancreatic and extrapancreatic AIP and the assessment of changes after steroid therapy.

MRI Prediction of Islet Yield for Autologous Transplantation After Total Pancreatectomy for Chronic Pancreatitis

“…Except for cysts and ductal disease, however, EUS features may be nonspecific, making prognostic judgment more challenging in less severe cases [13]. Magnetic resonance imaging (MRI) has been shown to enable effective detection of pathology in the pancreas and correlates with clinical features and the treatment of chronic autoimmune pancreatitis [14]. MRI is a non-invasive modality that avoids radiation, making it an ideal choice for routine study of these patients if it were found to be predictive of islet yield.…”

Differentiating Autoimmune Pancreatitis From Pancreatic Adenocarcinoma Using Dual-Phase Computed Tomography

“…However, in the presence of a biliary stent, it is not clear if the enhancement was reactive due to the presence of the stent or related to the disease process of AIP. Extrapancreatic manifestations of AIP, including non-cystic renal lesions and retroperitoneal fibrosis, have been previously reported 18, 19, 28 but were seen in only 3 and 2 patients, respectively. However, due to the rare occurrence of the extrapancreatic manifestations of AIP, statistical significance was not reached.…”

Autoimmune Pancreatitis

“…Pancreatic adenocarcinoma is hypovascular in all phases, whereas the focal type of AIP shows some degree of contrast retention in delayed phase due to severe inflammation and fibrosis. On MRI, pancreatic adenocarcinoma appears hypointense on T2-weighted images, while early AIP may show a subtle T2 hyperintense signal due to inflammation [12,27]. Diagnostic accuracy of the serum biomarker CA 19-9 is of limited value in differentiating focal AIP from pancreatic adenocarcinoma, as 9% of patients with AIP have elevated CA 19-9.…”