MRI assessment of chronic pancreatitis

Abstract

Magnetic resonance imaging (MRI) plays an important role in the assessment of chronic pancreatitis. By standard MRI techniques, decreased parenchymal signal on T1-weighted fat-suppressed images and delayed gradual enhancement on serial contrast enhanced images represent fibrotic changes caused by chronic inflammation. Magnetic resonance cholangiopancreaticography (MRCP) can reveal ductal changes, including side branch ectasias, that are related to tissue fibrosis and destruction. The exocrine function of the gland and an increased number of side branch ectasias can be evaluated with secretin-stimulated MRCP. Diffusion weighted imaging is an emerging technology that can complement standard MRI to assess the parenchymal changes associated with chronic pancreatitis. The same technique can also quantify the parenchymal response to secretin stimulation. This article reviews standard imaging techniques and new advancements in MRI technology as they relate to the assessment of chronic pancreatitis.