Pancreatitis-imaging approach

Abstract

Pancreatitis is defined as the inflammation of the pancreas and considered the most common pancreatic disease in children and adults. Imaging plays a significant role in the diagnosis, severity assessment, recognition of complications and guiding therapeutic interventions. In the setting of pancreatitis, wider availability and good image quality make multi-detector contrast-enhanced computed tomography (MD-CECT) the most used imaging technique. However, magnetic resonance imaging (MRI) offers diagnostic capabilities similar to those of CT, with additional intrinsic advantages including lack of ionizing radiation and exquisite soft tissue characterization. This article reviews the proposed definitions of revised Atlanta classification for acute pancreatitis, illustrates a wide range of morphologic pancreatic parenchymal and associated peripancreatic changes for different types of acute pancreatitis. It also describes the spectrum of early and late chronic pancreatitis imaging findings and illustrates some of the less common types of chronic pancreatitis, with special emphasis on the role of CT and MRI.

Imaging of abnormal liver function tests

“…When imaging is required, dual‐phase (arterial and venous) CECT is the best initial study. Acute interstitial pancreatitis is characterized by an enlarged and edematous pancreas with loss of normal fatty lobulation, peripancreatic fat stranding, edema and free fluid, although in mild pancreatitis imaging may be normal . MRCP is helpful in assessing the integrity of the pancreatic duct and is very sensitive for gallstones and other biliary pathology that may cause pancreatitis .…”

“…Acute interstitial pancreatitis is characterized by an enlarged and edematous pancreas with loss of normal fatty lobulation, peripancreatic fat stranding, edema and free fluid, although in mild pancreatitis imaging may be normal . MRCP is helpful in assessing the integrity of the pancreatic duct and is very sensitive for gallstones and other biliary pathology that may cause pancreatitis . US evaluation for pancreatitis is usually limited because the pancreas is partially or completely obscured by overlying bowel gas, although it may be useful in confirming or excluding the presence of stones or biliary dilatation …”

“…14,15 MRCP is helpful in assessing the integrity of the pancreatic duct and is very sensitive for gallstones and other biliary pathology that may cause pancreatitis. 15 US evaluation for pancreatitis is usually limited because the pancreas is partially or completely obscured by overlying bowel gas, although it may be useful in confirming or excluding the presence of stones or biliary dilatation. 15 The best initial imaging tool for acute cholecystitis is US.…”

“…15 US evaluation for pancreatitis is usually limited because the pancreas is partially or completely obscured by overlying bowel gas, although it may be useful in confirming or excluding the presence of stones or biliary dilatation. 15 The best initial imaging tool for acute cholecystitis is US. 16 US findings include pericholecystic fluid/abscess, gallbladder distension (>4 cm), a thickened gallbladder wall (>3 mm), and wall edema.…”

miR-155-5p is Negatively Associated with Acute Pancreatitis and Inversely Regulates Pancreatic Acinar Cell Progression by Targeting Rela and Traf3

“…It has been reported that the average incidence rate of AP is 19 cases per 100, 000 people per year [2]. Notably, the morbidity and mortality of severe acute pancreatitis (SAP) can reach 25-45% [3]. Considering the negative impact of AP on human health, it is urgent for us to clarify the mechanisms of occurrence and development of AP and investigate its potential therapeutic targets.…”