Imaging in chronic pancreatitis: State of the art review

Rohan Kamat; Pankaj Gupta; Surinder Rana

doi:10.4103/ijri.IJRI_484_18

Indian Journal of Radiology and Imaging, Table of Contents

CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(02): 201-210
DOI: 10.4103/ijri.IJRI_484_18

Hepatobiliary and Pancreatic Imaging

Imaging in chronic pancreatitis: State of the art review

Rohan Kamat

Department of Radiodiagnosis and Imaging, Chandigarh, India

,

Pankaj Gupta

Gastroenterology, PGIMER, Chandigarh, India

,

Surinder Rana

Department of Radiodiagnosis and Imaging, Chandigarh, India

› Author Affiliations
Subject Editor:

Abstract

Chronic pancreatitis (CP) is an important gastrointestinal cause of morbidity worldwide. It can severely impair the quality of life besides life-threatening acute and long-term complications. Pain and pancreatic exocrine insufficiency (leading to malnutrition) impact the quality of life. Acute complications include pseudocysts, pancreatic ascites, and vascular complications. Long-term complications are diabetes mellitus and pancreatic cancer. Early diagnosis of CP is crucial to alter the natural course of the disease. However, majority of the cases are diagnosed in the advanced stage. The role of various imaging techniques in the diagnosis of CP is discussed in this review.

Keywords

Chronic pancreatitis - diagnosis - imaging

Full Text

References

References
1 De Backer AI, Mortele KJ, Ros RR, Vanbeckevoort D, Vanschoubroeck I, De Keulenaer B. Chronic pancreatitis: Diagnostic role of computed tomography and magnetic resonance imaging. JBR-BTR 2002; 85: 304-10
2 Sharma R, Kandasamy D. Imaging in chronic pancreatitis. Pancreapedia Exocrine Pancreas Knowl Base 2015.
3 Perez-Johnston R, Sainani NI, Sahani DV. Imaging of chronic pancreatitis (including groove and autoimmune pancreatitis). Radiol Clin North Am 2012; 50: 447-66
4 Busireddy KK, AlObaidy M, Ramalho M, Kalubowila J, Baodong L, Santagostino I. et al. Pancreatitis-imaging approach. World J Gastrointest Pathophysiol 2014; 5: 252-70
5 Siddiqi AJ, Miller F. Chronic pancreatitis: Ultrasound, computed tomography, and magnetic resonance imaging features. Semin Ultrasound CT MRI 2007; 28: 384-94
6 Czeyda-Pommersheim Ferenc, Kalb B, Martin D. Imaging of chronic pancreatitis. In: Pancreatitis [Internet]. Wiley-Blackwell; 2017: 179-87
7 Issa Y, Kempeneers MA, van Santvoort HC, Bollen TL, Bipat S, Boermeester MA. Diagnostic performance of imaging modalities in chronic pancreatitis: A systematic review and meta-analysis. Eur Radiol 2017; 27: 3820-44
8 Choueiri NE, Balci NC, Alkaade S, Burton FR. Advanced imaging of chronic pancreatitis. Curr Gastroenterol Rep 2010; 12: 114-20
9 Graziani R, Tapparelli M, Malagò R, Girardi V, Frulloni L, Cavallini G. et al. The various imaging aspects of chronic pancreatitis. JOP. 2005; 6 (01) 73-88
10 Laterza L, Scaldaferri F, Bruno G, Agnes A, Boškoski I, Ianiro G. et al. Pancreatic function assessment. Eur Rev Med Pharmacol Sci 2013; 17 (02) 65-71
11 Chowdhury RS, Forsmark CE. Review article: Pancreatic function testing. Aliment Pharmacol Ther 2003; 17: 733-50
12 Siegmund E, Löhr JM, Schuff-Werner P. [The diagnostic validity of non-invasive pancreatic function tests-a meta-analysis]. Z Gastroenterol 2004; 42: 1117-28
13 Domínguez Muñoz JE. Diagnosis of chronic pancreatitis: Functional testing. Best Pract Res Clin Gastroenterol 2010; 24: 233-41
14 Dimcevski G, Erchinger FG, Havre R, Gilja OH. Ultrasonography in diagnosing chronic pancreatitis: New aspects. World J Gastroenterol 2013; 19: 7247-57
15 Alpern MB, Sandler MA, Kellman GM, Madrazo BL. Chronic pancreatitis: Ultrasonic features. Radiology 1985; 155: 215-9
16 Ammann RW, Muench R, Otto R, Buehler H, Freiburghaus AU, Siegenthaler W. Evolution and regression of pancreatic calcification in chronic pancreatitis: A prospective long-term study of 107 patients. Gastroenterology 1988; 95: 1018-28
17 Elmas N. The role of diagnostic radiology in pancreatitis. Eur J Radiol 2001; 38: 120-32
18 Wallace MB, Hawes RH. Endoscopic ultrasound in the evaluation and treatment of chronic pancreatitis. Pancreas 2001; 23: 26-35
19 Nattermann C, Goldschmidt AJ, Dancygier H. Endosonography in chronic pancreatitis-a comparison between endoscopic retrograde pancreatography and endoscopic ultrasonography. Endoscopy 1993; 25: 565-70
20 Catalano MF, Lahoti S, Geenen JE, Hogan WJ. Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis. Gastrointest Endosc 1998; 48: 11-7
21 Agarwal B, Krishna NB, Labundy JL, Safdar R, Akduman EI. EUS and/or EUS-guided FNA in patients with CT and/or magnetic resonance imaging findings of enlarged pancreatic head or dilated pancreatic duct with or without a dilated common bile duct. Gastrointest Endosc 2008; 68: 237-42
22 Raman SP, Fishman EK, Lennon AM. Endoscopic ultrasound and pancreatic applications: What the radiologist needs to know. Abdom Imaging 2013; 38: 1360-72
23 Kahl S, Glasbrenner B, Leodolter A, Pross M, Schulz HU, Malfertheiner P. EUS in the diagnosis of early chronic pancreatitis: A prospective follow-up study. Gastrointest Endosc 2002; 55: 507-11
24 Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W. et al. EUS-based criteria for the diagnosis of chronic pancreatitis: The Rosemont classification. Gastrointest Endosc 2009; 69: 1251-61
25 Guo J, Sun S. Endoscopic ultrasound for the diagnosis of chronic pancreatitis. Pancreapedia Exocrine Pancreas Knowl Base 2015.
26 Iglesias-García J, Lariño-Noia J, Lindkvist B, Domínguez-Muñoz JE. Endoscopic ultrasound in the diagnosis of chronic pancreatitis. Rev Esp Enfermedades Dig 2015; 107: 221-8
27 Fusaroli P, Spada A, Mancino MG, Caletti G. Contrast harmonic echo-endoscopic ultrasound improves accuracy in diagnosis of solid pancreatic masses. Clin Gastroenterol Hepatol 2010; 8: 629-34.e1-2
28 Pungpapong S, Wallace MB, Woodward TA, Noh KW, Raimondo M. Accuracy of endoscopic ultrasonography and magnetic resonance cholangiopancreatography for the diagnosis of chronic pancreatitis: A prospective comparison study. J Clin Gastroenterol 2007; 41: 88-93
29 Iglesias-Garcia J, Lindkvist B, Lariño-Noia J, Domínguez-Muñoz JE. Endoscopic ultrasound elastography. Endosc Ultrasound 2012; 1: 8-16
30 Kawada N, Tanaka S. Elastography for the pancreas: Current status and future perspective. World J Gastroenterol 2016; 22: 3712-24
31 Pozzi R, Parzanese I, Baccarin A, Giunta M, Conti CB, Cantù P. et al. Point shear-wave elastography in chronic pancreatitis: A promising tool for staging disease severity. Pancreatology 2017; 17: 905-10
32 Mateen MA, Muheet KA, Mohan RJ, Rao PN, Majaz HM, Rao GV. et al. Evaluation of ultrasound based acoustic radiation force impulse (ARFI) and eSie touch sonoelastography for diagnosis of inflammatory pancreatic diseases. JOP 2012; 13: 36-44
33 Iglesias-Garcia J, Domínguez-Muñoz JE, Castiñeira-Alvariño M, Luaces-Regueira M, Lariño-Noia J. Quantitative elastography associated with endoscopic ultrasound for the diagnosis of chronic pancreatitis. Endoscopy 2013; 45: 781-8
34 Domínguez-Muñoz JE, Alvarez-Castro A, Lariño-Noia J, Nieto L, Iglesias-García J. Endoscopic ultrasonography of the pancreas as an indirect method to predict pancreatic exocrine insufficiency in patients with chronic pancreatitis. Pancreas 2012; 41: 724-8
35 Luetmer PH, Stephens DH, Ward EM. Chronic pancreatitis: Reassessment with current CT. Radiology 1989; 171: 353-7
36 Remer EM, Baker ME. Imaging of chronic pancreatitis. Radiol Clin North Am 2002; 40: 1229-42
37 Miller FH, Keppke A, Balthazar E. Imaging Pancreatitis. Textbook of Gastrointestinal Radiology. 4th ed. 2015: 1809-37
38 Toprak O, Cirit M. Risk factors for contrast-induced nephropathy. Kidney Blood Press Res 2006; 29: 84-93
39 Frulloni L, Castellani C, Bovo P, Vaona B, Calore B, Liani C. et al. Natural history of pancreatitis associated with cystic fibrosis gene mutations. Dig Liver Dis 2003; 35: 179-85
40 Sinha A, Singh VK, Cruise M, Afghani E, Matsukuma K, Ali S. et al. Abdominal CT predictors of fibrosis in patients with chronic pancreatitis undergoing surgery. Eur Radiol 2015; 25: 1339-46
41 Irie H, Honda H, Baba S, Kuroiwa T, Yoshimitsu K, Tajima T. et al. Autoimmune pancreatitis: CT and MR characteristics. Am J Roentgenol 1998; 170: 1323-7
42 Jones SN, Lees WR, Frost RA. Diagnosis and grading of chronic pancreatitis by morphological criteria derived by ultrasound and pancreatography. Clin Radiol 1988; 39: 43-8
43 Kim DH, Pickhardt PJ. Radiologic assessment of acute and chronic pancreatitis. Surg Clin North Am 2007; 87: 1341-58
44 Miller FH, Keppke AL, Wadhwa A, Ly JN, Dalal K, Kamler VA. MRI of pancreatitis and its complications: Part 2, Chronic pancreatitis. Am J Roentgenol 2004; 183: 1645-52
45 Semelka RC, Ascher SM. MR imaging of the pancreas. Radiology 1993; 188: 593-602
46 Mitchell DG. MR imaging of the pancreas. Magn Reson Imaging Clin N Am 1995; 3: 51-71
47 Zhang XM, Shi H, Parker L, Dohke M, Holland GA, Mitchell DG. Suspected early or mild chronic pancreatitis: Enhancement patterns on gadolinium chelate dynamic MRI. Magnetic resonance imaging. J Magn Reson Imaging 2003; 17: 86-94
48 Balci NC, Alkaade S, Magas L, Momtahen AJ, Burton FR. Suspected chronic pancreatitis with normal MRCP: Findings on MRI in correlation with secretin MRCP. J Magn Reson Imaging 2008; 27: 125-31
49 Domínguez-Muñoz JE. editor Clinical Pancreatology for Practicing Gastroenterologists and Surgeons. Malden, Mass: Blackwell Publ; 2005: 535
50 Ly JN, Miller FH. MR imaging of the pancreas: A practical approach. Radiol Clin North Am 2002; 40: 1289-306
51 Balci C. MRI assessment of chronic pancreatitis. Diagn Interv Radiol 2011; 17: 249-54
52 Ralls PW, Halls J, Renner I, Juttner H. Endoscopic retrograde cholangiopancreatography (ERCP) in pancreatic disease: A reassessment of the specificity of ductal abnormalities in differentiating benign from malignant disease. Radiology 1980; 134: 347-52
53 Matos C, Cappeliez O, Winant C, Coppens E, Devière J, Metens T. MR imaging of the pancreas: A pictorial tour. Radiographics 2002; 22: e2
54 Bian Y, Wang L, Chen C, Lu JP, Fan JB, Chen SY. et al. Quantification of pancreatic exocrine function of chronic pancreatitis with secretin-enhanced MRCP. World J Gastroenterol 2013; 19: 7177-82
55 Brydon WG, Kingstone K, Ghosh S. Limitations of faecal elastase-1 and chymotrypsin as tests of exocrine pancreatic disease in adults. Ann Clin Biochem 2004; 41: 78-81
56 Erturk SM, Ichikawa T, Motosugi U, Sou H, Araki T. Diffusion-weighted MR imaging in the evaluation of pancreatic exocrine function before and after secretin stimulation. Am J Gastroenterol 2006; 101: 133-6
57 Robinson PJA, Sheridan MB. Pancreatitis: Computed tomography and magnetic resonance imaging. Eur Radiol 2000; 10: 401-8
58 Akisik MF, Aisen AM, Sandrasegaran K, Jennings SG, Lin C, Sherman S. et al. Assessment of chronic pancreatitis: Utility of diffusion-weighted MR imaging with secretin enhancement. Radiology 2009; 250: 103-9
59 Soto JA, Barish MA, Yucel EK, Clarke P, Siegenberg D, Chuttani R. et al. Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique. Radiology 1995; 196: 459-64
60 Lee TY, Kim M-H, Park DH, Seo DW, Lee SK, Kim JS. et al. Utility of 18F-FDG PET/CT for differentiation of autoimmune pancreatitis with atypical pancreatic imaging findings from pancreatic cancer. Am J Roentgenol 2009; 193: 343-8
61 Sahani DV, Bonaffini PA, Catalano OA, Guimaraes AR, Blake MA. State-of-the-Art PET/CT of the pancreas: Current role and emerging indications. Radiographics 2012; 27 (32) 1133-58
62 Imdahl A, Nitzsche E, Krautmann F, Högerle S, Boos S, Einert A. et al. Evaluation of positron emission tomography with 2-[18F] fluoro-2-deoxy-D-glucose for the differentiation of chronic pancreatitis and pancreatic cancer. Br J Surg 1999; 86: 194-9
63 Ozaki Y, Oguchi K, Hamano H, Arakura N, Muraki T, Kiyosawa K. et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography. J Gastroenterol 2008; 43: 144-51
64 van Kouwen MC, Jansen JB, van Goor H, de Castro S, Oyen WJ, Drenth JP. FDG-PET is able to detect pancreatic carcinoma in chronic pancreatitis. Eur J Nucl Med Mol Imaging 2005; 32: 399-404
65 Sah RP, Pannala R, Chari ST, Sugumar A, Clain JE, Levy MJ. et al. Prevalence, diagnosis, and profile of autoimmune pancreatitis presenting with features of acute or chronic pancreatitis. Clin Gastroenterol Hepatol 2010; 8: 91-6
66 Nishimori I, Tamakoshi A, Otsuki M. Research Committee on Intractable Diseases of the Pancreas, Ministry of Health, Labour, and Welfare of Japan. Prevalence of autoimmune pancreatitis in Japan from a nationwide survey in 2002. J Gastroenterol 2007; 42 Suppl (18) 6-8
67 Takahashi N, Fletcher JG, Fidler JL, Hough DM, Kawashima A, Chari ST. Dual-phase CT of autoimmune pancreatitis: A multireader study. Am J Roentgenol 2008; 190: 280-6
68 Blasbalg R, Baroni RH, Costa DN, Machado MCC. MRI features of groove pancreatitis. Am J Roentgenol 2007; 189: 73-80
69 Chatelain D, Vibert E, Yzet T, Geslin G, Bartoli E, Manaouil D. et al. Groove pancreatitis and pancreatic heterotopia in the minor duodenal papilla. Pancreas 2005; 30: e92-5
70 Raman SP, Salaria SN, Hruban RH, Fishman EK. Groove pancreatitis: Spectrum of imaging findings and radiology-pathology correlation. Am J Roentgenol 2013; 201: W29-39
71 Yin Q, Zou X, Zai X, Wu Z, Wu Q, Jiang X. et al. Pancreatic ductal adenocarcinoma and chronic mass-forming pancreatitis: Differentiation with dual-energy MDCT in spectral imaging mode. Eur J Radiol 2015; 84: 2470-6