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Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

Hwang JY, Yoon HK, Kim KM - Pediatr Gastroenterol Hepatol Nutr (2015)

Bottom Line: Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children.Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology.This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

No MeSH data available.


Related in: MedlinePlus

A 4-year-old female with hereditary pancreatitis (SPINK1 mutation) and pancreas divisum. (A) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography (MRCP) image showing 3 pancreatoliths in the downstream minor pancreatic duct (arrowheads). Note the diffuse dilation of the pancreatic duct (arrow) (B) Volume-rendering 3-dimensional MRCP image clearly depicting the dilated minor pancreatic duct crossing over the distal common bile duct (arrow), which drains into the minor papilla (pancreas divisum). The irregularity of the upstream duct can also be seen (curved arrow).
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Figure 4: A 4-year-old female with hereditary pancreatitis (SPINK1 mutation) and pancreas divisum. (A) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography (MRCP) image showing 3 pancreatoliths in the downstream minor pancreatic duct (arrowheads). Note the diffuse dilation of the pancreatic duct (arrow) (B) Volume-rendering 3-dimensional MRCP image clearly depicting the dilated minor pancreatic duct crossing over the distal common bile duct (arrow), which drains into the minor papilla (pancreas divisum). The irregularity of the upstream duct can also be seen (curved arrow).

Mentions: Chronic pancreatitis is defined by irreversible architectural and functional changes in the pancreas due to long-standing pancreatic inflammation and injury [6]. It has been noted that chronic pediatric pancreatitis is mainly associated with obstructive and genetic causes [9]. MRCP can identify irregular ductal dilatation with or without stricture, calculi, and pseudocyst (Fig. 3 and 4). However, MRI has some limitations when identifying parenchymal calcifications and small pancreaticoliths or abnormalities in the small distal duct. Therefore, there have been attempts to combine MRI and unenhanced CT in order to diagnose chronic pancreatitis [10].


Characteristics of Pediatric Pancreatitis on Magnetic Resonance Cholangiopancreatography.

Hwang JY, Yoon HK, Kim KM - Pediatr Gastroenterol Hepatol Nutr (2015)

A 4-year-old female with hereditary pancreatitis (SPINK1 mutation) and pancreas divisum. (A) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography (MRCP) image showing 3 pancreatoliths in the downstream minor pancreatic duct (arrowheads). Note the diffuse dilation of the pancreatic duct (arrow) (B) Volume-rendering 3-dimensional MRCP image clearly depicting the dilated minor pancreatic duct crossing over the distal common bile duct (arrow), which drains into the minor papilla (pancreas divisum). The irregularity of the upstream duct can also be seen (curved arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493250&req=5

Figure 4: A 4-year-old female with hereditary pancreatitis (SPINK1 mutation) and pancreas divisum. (A) Single-shot radial acquisition with relaxation enhancement magnetic resonance cholangiopancreatography (MRCP) image showing 3 pancreatoliths in the downstream minor pancreatic duct (arrowheads). Note the diffuse dilation of the pancreatic duct (arrow) (B) Volume-rendering 3-dimensional MRCP image clearly depicting the dilated minor pancreatic duct crossing over the distal common bile duct (arrow), which drains into the minor papilla (pancreas divisum). The irregularity of the upstream duct can also be seen (curved arrow).
Mentions: Chronic pancreatitis is defined by irreversible architectural and functional changes in the pancreas due to long-standing pancreatic inflammation and injury [6]. It has been noted that chronic pediatric pancreatitis is mainly associated with obstructive and genetic causes [9]. MRCP can identify irregular ductal dilatation with or without stricture, calculi, and pseudocyst (Fig. 3 and 4). However, MRI has some limitations when identifying parenchymal calcifications and small pancreaticoliths or abnormalities in the small distal duct. Therefore, there have been attempts to combine MRI and unenhanced CT in order to diagnose chronic pancreatitis [10].

Bottom Line: Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children.Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology.This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.

ABSTRACT
Pediatric pancreatitis is not uncommon and results in considerable morbidity and mortality in the affected children. Unlike adults, pediatric pancreatitis is more frequently associated with underlying structural abnormalities, trauma, and drugs rather than an idiopathic etiology. Magnetic resonance cholangiopancreatography (MRCP) is a good imaging modality for evaluating pancreatitis and determining etiology without exposure to radiation. This article focuses on MRCP findings associated with various causes of pancreatitis in children, particularly structural abnormalities of the pancreaticobiliary system, as well as describing the feasibility, limitations, and solutions associated with pediatric MRCP.

No MeSH data available.


Related in: MedlinePlus