Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP
Purpose This study retrospectively determined magnetic resonance (MR), MR cholangiopancreatography (MRCP) and secretin-MRCP findings in patients with autoimmune pancreatitis (AIP). Materials and methods The MR examinations of 28 patients with histopathologically proven AIP were reviewed. In 14 cases...
Gespeichert in:
| Veröffentlicht in: | Radiologia medica 2009-12, Vol.114 (8), p.1214-1231 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1231 |
|---|---|
| container_issue | 8 |
| container_start_page | 1214 |
| container_title | Radiologia medica |
| container_volume | 114 |
| creator | Carbognin, G. Girardi, V. Biasiutti, C. Camera, L. Manfredi, R. Frulloni, L. Hermans, J.J. Pozzi Mucelli, R. |
| description | Purpose
This study retrospectively determined magnetic resonance (MR), MR cholangiopancreatography (MRCP) and secretin-MRCP findings in patients with autoimmune pancreatitis (AIP).
Materials and methods
The MR examinations of 28 patients with histopathologically proven AIP were reviewed. In 14 cases, secretin-enhanced MRCP was performed. The observers evaluated pancreatic parenchymal enlargement, signal intensity abnormalities, enhancement, vascular involvement, bile-duct diameter and main pancreatic duct (MPD) narrowing (diffuse/focal/segmental). After secretin administration, the presence of the “duct-penetrating” sign was evaluated.
Results
MR imaging showed diffuse pancreatic enlargement in 8/28(29%) cases, focal pancreatic enlargement in 16/28 (57%) cases and no enlargement in 4/28 (14%) cases. The alteration of pancreatic signal intensity was diffuse in 8/28 (29%) cases (eight diffuse AIP) and focal in 20/28 (71%) cases (20 focal AIP). Delayed pancreatic enhancement was present in all AIP, with peripheral rim of enhancement in 8/28 (29%) AIP (1/8 diffuse, 7/20 focal); vascular encasement was present in 7/28 (25%) AIP (1/8 diffuse, 6/20 focal); distal common bile duct narrowing was present in 12/28(43%) AIP (5/8 diffuse, 7/20 focal). MRCP showed MPD narrowing in 17/28 (61%) AIP (4/8 diffuse, 15/20 focal), MPD dilation in 8/28(29%) AIP (3/8 diffuse, 5/20 focal) and normal MPD in1/8 diffuse AIP. Secretin-MRCP showed the duct-penetrating sign in 6/14(43%) AIP (one diffuse AIP with MPD segmental narrowing, five focal AIP with MPD focal narrowing), demonstrating integrity of the MPD.
Conclusions
Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma. |
| doi_str_mv | 10.1007/s11547-009-0452-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_745977978</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>734253321</sourcerecordid><originalsourceid>FETCH-LOGICAL-c371t-b94277057858530d5ac486668787da293603ea37a15283c27ca8514440dda9003</originalsourceid><addsrcrecordid>eNqFkUtPWzEQhS3UqgTaH8AGeccG0_Hr2u4ORbwkUFFF15axneAo1zfY9y749zhKJLqii9Es5pujmXMQOqFwQQHUz0qpFIoAGAJCMgIHaEY160hnNP-CZgCcE807doiOal0BCKBgvqFDapQ2RpoZWl1O45D6fsoRb1z2Jboxjan-wql3y5SXeJFyaL3iIWM_5LG4OpKYXxocA374c95q_ohdDji8Zdcnj2tsOmPK_2Lzx-_o68Kta_yx78fo7_XV0_yW3P--uZtf3hPPFR3JsxFMKZBKSy05BOm80F3XaaVVcMzwDnh0XDkqmeaeKe-0pEIICMGZ9vIxOtvpbsrwOsU62j5VH9drl-MwVauENEo1B_5PcsEk54w2ku5IX4ZaS1zYTWkGlTdLwW6zsLssbMvCbrOw2ztO9-rTcx_Dx8be_AawHVDbKC9jsathKrl584nqO1PWkoA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>734253321</pqid></control><display><type>article</type><title>Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Carbognin, G. ; Girardi, V. ; Biasiutti, C. ; Camera, L. ; Manfredi, R. ; Frulloni, L. ; Hermans, J.J. ; Pozzi Mucelli, R.</creator><creatorcontrib>Carbognin, G. ; Girardi, V. ; Biasiutti, C. ; Camera, L. ; Manfredi, R. ; Frulloni, L. ; Hermans, J.J. ; Pozzi Mucelli, R.</creatorcontrib><description>Purpose
This study retrospectively determined magnetic resonance (MR), MR cholangiopancreatography (MRCP) and secretin-MRCP findings in patients with autoimmune pancreatitis (AIP).
Materials and methods
The MR examinations of 28 patients with histopathologically proven AIP were reviewed. In 14 cases, secretin-enhanced MRCP was performed. The observers evaluated pancreatic parenchymal enlargement, signal intensity abnormalities, enhancement, vascular involvement, bile-duct diameter and main pancreatic duct (MPD) narrowing (diffuse/focal/segmental). After secretin administration, the presence of the “duct-penetrating” sign was evaluated.
Results
MR imaging showed diffuse pancreatic enlargement in 8/28(29%) cases, focal pancreatic enlargement in 16/28 (57%) cases and no enlargement in 4/28 (14%) cases. The alteration of pancreatic signal intensity was diffuse in 8/28 (29%) cases (eight diffuse AIP) and focal in 20/28 (71%) cases (20 focal AIP). Delayed pancreatic enhancement was present in all AIP, with peripheral rim of enhancement in 8/28 (29%) AIP (1/8 diffuse, 7/20 focal); vascular encasement was present in 7/28 (25%) AIP (1/8 diffuse, 6/20 focal); distal common bile duct narrowing was present in 12/28(43%) AIP (5/8 diffuse, 7/20 focal). MRCP showed MPD narrowing in 17/28 (61%) AIP (4/8 diffuse, 15/20 focal), MPD dilation in 8/28(29%) AIP (3/8 diffuse, 5/20 focal) and normal MPD in1/8 diffuse AIP. Secretin-MRCP showed the duct-penetrating sign in 6/14(43%) AIP (one diffuse AIP with MPD segmental narrowing, five focal AIP with MPD focal narrowing), demonstrating integrity of the MPD.
Conclusions
Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma.</description><identifier>ISSN: 0033-8362</identifier><identifier>EISSN: 1826-6983</identifier><identifier>DOI: 10.1007/s11547-009-0452-0</identifier><identifier>PMID: 19789959</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Abdominal Radiology/Radiologia Addominale ; Adult ; Aged ; Autoimmune Diseases - diagnostic imaging ; Autoimmune Diseases - pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Contrast Media ; Diagnosis, Differential ; Diagnostic Radiology ; Female ; Gastrointestinal Agents ; Hormones ; Humans ; Imaging ; Interventional Radiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neuroradiology ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatitis - diagnosis ; Pancreatitis - diagnostic imaging ; Radiology ; Retrospective Studies ; Risk Factors ; Secretin ; Sensitivity and Specificity ; Ultrasound</subject><ispartof>Radiologia medica, 2009-12, Vol.114 (8), p.1214-1231</ispartof><rights>Springer-Verlag Italia 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c371t-b94277057858530d5ac486668787da293603ea37a15283c27ca8514440dda9003</citedby><cites>FETCH-LOGICAL-c371t-b94277057858530d5ac486668787da293603ea37a15283c27ca8514440dda9003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11547-009-0452-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11547-009-0452-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19789959$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carbognin, G.</creatorcontrib><creatorcontrib>Girardi, V.</creatorcontrib><creatorcontrib>Biasiutti, C.</creatorcontrib><creatorcontrib>Camera, L.</creatorcontrib><creatorcontrib>Manfredi, R.</creatorcontrib><creatorcontrib>Frulloni, L.</creatorcontrib><creatorcontrib>Hermans, J.J.</creatorcontrib><creatorcontrib>Pozzi Mucelli, R.</creatorcontrib><title>Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP</title><title>Radiologia medica</title><addtitle>Radiol med</addtitle><addtitle>Radiol Med</addtitle><description>Purpose
This study retrospectively determined magnetic resonance (MR), MR cholangiopancreatography (MRCP) and secretin-MRCP findings in patients with autoimmune pancreatitis (AIP).
Materials and methods
The MR examinations of 28 patients with histopathologically proven AIP were reviewed. In 14 cases, secretin-enhanced MRCP was performed. The observers evaluated pancreatic parenchymal enlargement, signal intensity abnormalities, enhancement, vascular involvement, bile-duct diameter and main pancreatic duct (MPD) narrowing (diffuse/focal/segmental). After secretin administration, the presence of the “duct-penetrating” sign was evaluated.
Results
MR imaging showed diffuse pancreatic enlargement in 8/28(29%) cases, focal pancreatic enlargement in 16/28 (57%) cases and no enlargement in 4/28 (14%) cases. The alteration of pancreatic signal intensity was diffuse in 8/28 (29%) cases (eight diffuse AIP) and focal in 20/28 (71%) cases (20 focal AIP). Delayed pancreatic enhancement was present in all AIP, with peripheral rim of enhancement in 8/28 (29%) AIP (1/8 diffuse, 7/20 focal); vascular encasement was present in 7/28 (25%) AIP (1/8 diffuse, 6/20 focal); distal common bile duct narrowing was present in 12/28(43%) AIP (5/8 diffuse, 7/20 focal). MRCP showed MPD narrowing in 17/28 (61%) AIP (4/8 diffuse, 15/20 focal), MPD dilation in 8/28(29%) AIP (3/8 diffuse, 5/20 focal) and normal MPD in1/8 diffuse AIP. Secretin-MRCP showed the duct-penetrating sign in 6/14(43%) AIP (one diffuse AIP with MPD segmental narrowing, five focal AIP with MPD focal narrowing), demonstrating integrity of the MPD.
Conclusions
Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma.</description><subject>Abdominal Radiology/Radiologia Addominale</subject><subject>Adult</subject><subject>Aged</subject><subject>Autoimmune Diseases - diagnostic imaging</subject><subject>Autoimmune Diseases - pathology</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Cholangiopancreatography, Magnetic Resonance</subject><subject>Contrast Media</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic Radiology</subject><subject>Female</subject><subject>Gastrointestinal Agents</subject><subject>Hormones</subject><subject>Humans</subject><subject>Imaging</subject><subject>Interventional Radiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neuroradiology</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatitis - diagnosis</subject><subject>Pancreatitis - diagnostic imaging</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Secretin</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasound</subject><issn>0033-8362</issn><issn>1826-6983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtPWzEQhS3UqgTaH8AGeccG0_Hr2u4ORbwkUFFF15axneAo1zfY9y749zhKJLqii9Es5pujmXMQOqFwQQHUz0qpFIoAGAJCMgIHaEY160hnNP-CZgCcE807doiOal0BCKBgvqFDapQ2RpoZWl1O45D6fsoRb1z2Jboxjan-wql3y5SXeJFyaL3iIWM_5LG4OpKYXxocA374c95q_ohdDji8Zdcnj2tsOmPK_2Lzx-_o68Kta_yx78fo7_XV0_yW3P--uZtf3hPPFR3JsxFMKZBKSy05BOm80F3XaaVVcMzwDnh0XDkqmeaeKe-0pEIICMGZ9vIxOtvpbsrwOsU62j5VH9drl-MwVauENEo1B_5PcsEk54w2ku5IX4ZaS1zYTWkGlTdLwW6zsLssbMvCbrOw2ztO9-rTcx_Dx8be_AawHVDbKC9jsathKrl584nqO1PWkoA</recordid><startdate>20091201</startdate><enddate>20091201</enddate><creator>Carbognin, G.</creator><creator>Girardi, V.</creator><creator>Biasiutti, C.</creator><creator>Camera, L.</creator><creator>Manfredi, R.</creator><creator>Frulloni, L.</creator><creator>Hermans, J.J.</creator><creator>Pozzi Mucelli, R.</creator><general>Springer Milan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20091201</creationdate><title>Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP</title><author>Carbognin, G. ; Girardi, V. ; Biasiutti, C. ; Camera, L. ; Manfredi, R. ; Frulloni, L. ; Hermans, J.J. ; Pozzi Mucelli, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c371t-b94277057858530d5ac486668787da293603ea37a15283c27ca8514440dda9003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Abdominal Radiology/Radiologia Addominale</topic><topic>Adult</topic><topic>Aged</topic><topic>Autoimmune Diseases - diagnostic imaging</topic><topic>Autoimmune Diseases - pathology</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Cholangiopancreatography, Magnetic Resonance</topic><topic>Contrast Media</topic><topic>Diagnosis, Differential</topic><topic>Diagnostic Radiology</topic><topic>Female</topic><topic>Gastrointestinal Agents</topic><topic>Hormones</topic><topic>Humans</topic><topic>Imaging</topic><topic>Interventional Radiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neuroradiology</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatitis - diagnosis</topic><topic>Pancreatitis - diagnostic imaging</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Secretin</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carbognin, G.</creatorcontrib><creatorcontrib>Girardi, V.</creatorcontrib><creatorcontrib>Biasiutti, C.</creatorcontrib><creatorcontrib>Camera, L.</creatorcontrib><creatorcontrib>Manfredi, R.</creatorcontrib><creatorcontrib>Frulloni, L.</creatorcontrib><creatorcontrib>Hermans, J.J.</creatorcontrib><creatorcontrib>Pozzi Mucelli, R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Radiologia medica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carbognin, G.</au><au>Girardi, V.</au><au>Biasiutti, C.</au><au>Camera, L.</au><au>Manfredi, R.</au><au>Frulloni, L.</au><au>Hermans, J.J.</au><au>Pozzi Mucelli, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP</atitle><jtitle>Radiologia medica</jtitle><stitle>Radiol med</stitle><addtitle>Radiol Med</addtitle><date>2009-12-01</date><risdate>2009</risdate><volume>114</volume><issue>8</issue><spage>1214</spage><epage>1231</epage><pages>1214-1231</pages><issn>0033-8362</issn><eissn>1826-6983</eissn><abstract>Purpose
This study retrospectively determined magnetic resonance (MR), MR cholangiopancreatography (MRCP) and secretin-MRCP findings in patients with autoimmune pancreatitis (AIP).
Materials and methods
The MR examinations of 28 patients with histopathologically proven AIP were reviewed. In 14 cases, secretin-enhanced MRCP was performed. The observers evaluated pancreatic parenchymal enlargement, signal intensity abnormalities, enhancement, vascular involvement, bile-duct diameter and main pancreatic duct (MPD) narrowing (diffuse/focal/segmental). After secretin administration, the presence of the “duct-penetrating” sign was evaluated.
Results
MR imaging showed diffuse pancreatic enlargement in 8/28(29%) cases, focal pancreatic enlargement in 16/28 (57%) cases and no enlargement in 4/28 (14%) cases. The alteration of pancreatic signal intensity was diffuse in 8/28 (29%) cases (eight diffuse AIP) and focal in 20/28 (71%) cases (20 focal AIP). Delayed pancreatic enhancement was present in all AIP, with peripheral rim of enhancement in 8/28 (29%) AIP (1/8 diffuse, 7/20 focal); vascular encasement was present in 7/28 (25%) AIP (1/8 diffuse, 6/20 focal); distal common bile duct narrowing was present in 12/28(43%) AIP (5/8 diffuse, 7/20 focal). MRCP showed MPD narrowing in 17/28 (61%) AIP (4/8 diffuse, 15/20 focal), MPD dilation in 8/28(29%) AIP (3/8 diffuse, 5/20 focal) and normal MPD in1/8 diffuse AIP. Secretin-MRCP showed the duct-penetrating sign in 6/14(43%) AIP (one diffuse AIP with MPD segmental narrowing, five focal AIP with MPD focal narrowing), demonstrating integrity of the MPD.
Conclusions
Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>19789959</pmid><doi>10.1007/s11547-009-0452-0</doi><tpages>18</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0033-8362 |
| ispartof | Radiologia medica, 2009-12, Vol.114 (8), p.1214-1231 |
| issn | 0033-8362 1826-6983 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_745977978 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Radiology/Radiologia Addominale Adult Aged Autoimmune Diseases - diagnostic imaging Autoimmune Diseases - pathology Cholangiopancreatography, Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Contrast Media Diagnosis, Differential Diagnostic Radiology Female Gastrointestinal Agents Hormones Humans Imaging Interventional Radiology Male Medicine Medicine & Public Health Middle Aged Neuroradiology Pancreatic Neoplasms - diagnostic imaging Pancreatitis - diagnosis Pancreatitis - diagnostic imaging Radiology Retrospective Studies Risk Factors Secretin Sensitivity and Specificity Ultrasound |
| title | Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T11%3A08%3A25IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Autoimmune%20pancreatitis:%20imaging%20findings%20on%20contrast-enhanced%20MR,%20MRCP%20and%20dynamic%20secretin-enhanced%20MRCP&rft.jtitle=Radiologia%20medica&rft.au=Carbognin,%20G.&rft.date=2009-12-01&rft.volume=114&rft.issue=8&rft.spage=1214&rft.epage=1231&rft.pages=1214-1231&rft.issn=0033-8362&rft.eissn=1826-6983&rft_id=info:doi/10.1007/s11547-009-0452-0&rft_dat=%3Cproquest_cross%3E734253321%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=734253321&rft_id=info:pmid/19789959&rfr_iscdi=true |