EURORAD ESR

Case 10588

Diagnosis of groove pancreatitis in patient with chronic pancreatitis and recurrent abdominal pain

Author(s)
Cervelli R, Lorenzoni G, Gabelloni M, Fiorini S, Quaglia FM, Signorini F, Cappelli C, Bartolozzi C

Department of Diagnostic and Interventional Radiology,
University Hospital of Pisa, Italy
 
Patient
male, 62 year(s)
 
 
  • Figure 1
    2011 MRI, first diagnosis of chronic pancreatitis
     

    T1-weighted MR image shows a focal lesion of 12mm in pancreatic head. It is hypointense with a hyperintense central area, suggesting necrotic material and bleeding.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;

    The arrow shows the lesion in Fat-suppressed T2-weighted MR image: hyperintense with a hypointense central area.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;

    Non-fat-suppressed T2-weighted MR images show hyperintense cystic lesion (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Pathology;
     
     
  • Figure 2
    2011 MRCP

    Magnetic resonance cholangiopancreatography revealed cystic changes and thickening of duodenal wall. The biliary tree does not show abnormality.

     
    Area of Interest: Abdomen; Imaging Technique: MR; Procedure: Colonography MR; Special Focus: Pathology;
     
     
  • Figure 3
    CT 2012

    TC documents walls thickening of duodenum and cysts in its medial wall. The lesions have regular walls and hypodense content in arterial, venous phases (A,B,C),while in late phase (D) show contrastographic uptake.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Pathology;
     
     
  • Figure 4
    Associated signs detected at CT
     

    CT detects a complex mass arising from pancreatic head. The mass presents both solid and cystic components.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Pathology;

    The figure shows the regularity of the bile ducts that are not involved in this disease process.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Pathology;

    Normal appearance of the remaining gland: focus on the tail of pancreas (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Pathology;
     
     
  • Figure 5
    Location of cystic dystrophy

    Inflammation is predominantly centered in the pancreaticoduodenal groove, with multiple cystic lesions within the medial wall of the duodenum (D).

     
    Area of Interest: Abdomen; Imaging Technique: Image manipulation / Reconstruction; Procedure: Imaging sequences; Special Focus: Pathology;
     
     
T1-weighted MR image shows a focal lesion of 12mm in pancreatic head. It is hypointense with a hyperintense central area, suggesting necrotic material and bleeding.
 
The arrow shows the lesion in Fat-suppressed T2-weighted MR image: hyperintense with a hypointense central area.
 
Non-fat-suppressed T2-weighted MR images show hyperintense cystic lesion (arrow).
 
Magnetic resonance cholangiopancreatography revealed cystic changes and thickening of duodenal wall. The biliary tree does not show abnormality.
 
TC documents walls thickening of duodenum and cysts in its medial wall. The lesions have regular walls and hypodense content in arterial, venous phases (A,B,C),while in late phase (D) show contrastographic uptake.
 
CT detects a complex mass arising from pancreatic head. The mass presents both solid and cystic components.
 
The figure shows the regularity of the bile ducts that are not involved in this disease process.
 
Normal appearance of the remaining gland: focus on the tail of pancreas (arrow).
 
Inflammation is predominantly centered in the pancreaticoduodenal groove, with multiple cystic lesions within the medial wall of the duodenum (D).
 
 
 
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