MRI of Groove Pancreatitis

“…The pancreatic head is involved in the segmental form of GP, and a focal mass-like lesion adjacent to the groove area is appreciated along with dilatation of the main pancreatic duct. The mass in the groove and/or the pancreatic head is hypointense to pancreatic parenchyma on T1-weighted images and iso-to slightly hyperintense on T2-weighted images [24]. This variation in the T2 signal has been related with the duration of the disease, since subacute disease exhibits brighter T2 images because of edema, and chronic disease has lower signal because of fibrosis [25].…”

Section: Imaging Methods-findingsmentioning

confidence: 99%

“…It provides images almost equal to those of endoscopic retrograde cholangiopancreatography (ERCP) in a noninvasive manner. Furthermore, in patients with groove pancreatitis, duodenal stenosis often precludes ERCP, while there is usually incomplete opacification of the pancreaticobiliary system in GP, and images are considered of lesser diagnostic value than MRCP [24]. Therefore, MRCP is the primary imaging modality for the visualization of the pancreatic and biliary ducts in GP.…”

Section: Imaging Methods-findingsmentioning

confidence: 99%

Groove pancreatitis: a diagnostic challenge

et al. 2009

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Groove pancreatitis is a distinct form of chronic pancreatitis characterized by inflammation and fibrous tissue formation, affecting the groove area between the head of the pancreas, the duodenum and the common bile duct. It is manifested on imaging by a sheet-like mass in the groove area near the minor papilla. Thickening of the duodenal wall and cystic transformation in the duodenal wall also represent common imaging features. Pathogenesis is still unclear, and clinical presentation is not specific. Endoscopic ultrasonography (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) demonstrate imaging findings consistent with the disease in typical cases, but specific diagnosis is challenging in a number of patients where biopsy is required. The disease may mimic pancreatic, common bile duct or duodenal wall cancer that requires prompt and excessive surgical intervention, as opposed to groove pancreatitis where initial conservative treatment is suggested. The clinical, histopathological and radiological features on cross-sectional imaging of this entity are discussed in this review, and differential diagnostic clues are given.

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“…MRI shows a sheet-like mass in the groove area, which is hypointense relative to the pancreatic parenchyma on T 1 -weighted images, and iso- to slightly hypointense on T 2 -weighted images [17]. Such masses that are hyperintense on T 2 -weighted images at the subacute inflammatory period become hypointense due to fibrosis, but the parenchyma of the pancreatic head is hyperintense.…”

Section: Diagnosismentioning

confidence: 99%

Groove Pancreatitis

et al. 2010

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Groove pancreatitis is a segmental chronic pancreatitis that affects the anatomical area between the pancreatic head, the duodenum, and the common bile duct, referred to as the groove area. Most patients with groove pancreatitis are males aged 40–50 years with a history of alcohol abuse. In about 20% of patients undergoing pancreaticoduodenectomy to treat chronic pancreatitis, groove pancreatitis is detected. The clinical symptoms are weight loss, upper abdominal pain, postprandial vomiting, and nausea due to duodenal stenosis. The pathogenesis of groove pancreatitis is thought to be anatomical or functional obstruction of the minor papilla. The viscosity of pancreatic juice increases due to excessive alcohol consumption and/or smoking, leading to calcification of the pancreatic duct. According to these conditions, pancreatitis in the groove area might arise due to impaired pancreatic juice outflow. The descending part of the duodenum is usually stenotic. Severe fibrosis and scarring are evident in the groove area. Characteristic pathological findings are cystic lesions in the duodenal wall, Brunner gland hyperplasia, dilation of Santorini’s duct and protein plaques in the pancreatic duct. A differential diagnosis of groove pancreatitis from peripancreatic cancer is clinically important. Cystic lesions in the duodenal wall and smooth stenosis of the bile duct are important findings of groove pancreatitis revealed by endoscopic ultrasonography, computed tomography and magnetic resonance imaging. Biopsy through the duodenum is also useful for diagnosis. Conservative treatment options include endoscopic stenting of the minor papilla, but long-term outcomes remain unclear. Pancreatoduodenectomy is a rational treatment for symptomatic groove pancreatitis.

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MRI of Groove Pancreatitis

Abstract: MR images can clearly demonstrate the fibrous tissue in the groove in groove pancreatitis, and MR cholangiopancreatography can also provide useful information.

Cited by 86 publications

References 8 publications

Groove (paraduodenal) pancreatitis: Report of two cases

Groove (paraduodenal) pancreatitis: Report of two cases

Groove pancreatitis: a diagnostic challenge

Groove Pancreatitis

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