CT and MRI features of chronic pancreatitis

What are the CT and MRI features of chronic pancreatitis?

Chronic pancreatitis is secondary to prolonged inflammation with associated fibrotic change and is most often encountered in the setting of alcoholism. On CT and MRI, pancreatic parenchymal atrophy with fatty change and focal calcifications are characteristically seen. Irregular or beaded dilation of the main pancreatic duct and side branches, often with focal strictures or intraductal calculi, is also seen.

Sometimes, focal pancreatic enlargement mimicking a pancreatic neoplasm may occur, which may require tissue sampling for definitive diagnosis.

However, the “penetrating duct” sign may also sometimes be present, where a normal or minimally narrowed pancreatic duct passes through the region of focal pancreatic enlargement, which is more suggestive of a nonneoplastic etiology.

Additional findings such as pseudocyst formation or splenic vein thrombosis may also be present.


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