Reporting Standards for Chronic Pancreatitis by Using CT, MRI, and MR Cholangiopancreatography: The Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer

Abstract

hronic pancreatitis (CP) is an inflammatory condition of the pancreas. Clinical manifestations of CP include one or more of the following: abdominal pain, which is often chronic and debilitating; episode(s) of acute pancreatitis; endocrine and/or exocrine insufficiency; and in some cases, development of pancreatic cancer. CP has a profound impact on the patient's quality of life (1). The natural course of CP is highly variable and no validated tools exist to predict disease progression in individual patients. There are no specific therapies available for treatment or prevention of this disease. Mechanistic definition and conceptual framework for disease evolution recently proposed based on international consensus (2) provides an opportunity to conduct translational and interventional studies to generate empirical data to advance the field.The histologic hallmarks of CP include fibrosis, chronic inflammation, and loss of acinar cells. Because histologic diagnosis is rarely pursued given the potential for complications, there is a need for a noninvasive biomarker of pancreatic fibrosis. This biomarker can be used in future trials to evaluate the efficacy of therapeutic agents, which may slow the progression or reverse the fibrosis observed in CP.Cross-sectional imaging is the most commonly used method to establish a diagnosis of acute pancreatitis and CP. Among cross-sectional imaging studies, CT is readily available and performed often in the setting of acute pancreatitis. It is widely acknowledged that MRI with MR cholangiopancreatography is more sensitive than is CT for detection of ductal and subtle parenchymal changes, especially during early stages of CP (3,4). However, the two

EUS pancreatic function testing and dynamic pancreatic duct evaluation for the diagnosis of exocrine pancreatic insufficiency and chronic pancreatitis

“…Because magnetic resonance imaging with intravenous contrast may produce or detect abnormalities such as signal differences on T1 imaging, gland atrophy, and irregular outer margins, 23,29 we postulated that the pancreatic duct and parenchyma may produce sonographic changes after secretin. In patients with normal exocrine function, post-secretin imaging showed parenchymal hyperechoic foci and strands, and MPD echogenic walls were more visible compared with the EPI group.…”

Comparison of CT and MRI images for the prediction of soft-tissue sarcoma grading and lung metastasis via a convolutional neural networks model

“…According to previous studies, MRI is usually a more optimal method to identify the soft-tissue lesions than CT. 23 MRI can provide high-resolution imaging for soft tissues, so it can distinguish degrees of lesions better than CT. Several found that MRI could identify local recurrence better than CT with better sensitivity and specificity. 24 Surprisingly, the present model achieved comparable results using the CT and T1W MRI datasets for predicting STS grading.…”

Diabetes mellitus, chronic pancreatitis and primary hyperparathyroidism: is there a connection?

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