Pancreatic parenchymal and intraductal calcification virtually diagnostic of chronic pancreatitis

• MR: More sensitive for early changes compared to CT










IMAGING
General Features
MR Findings
• Normal MR appearance of pancreas
• More sensitive for early changes of chronic pancreatitis compared to CT (although less sensitive for calcifications)
Loss of normal high T1WI signal of parenchyma (due to fibrosis replacing parenchymal proteinaceous fluid)

• Changes in pancreatic duct (usually later finding) nicely demonstrated on T2WI or MRCP
Radiographic Findings
• Radiography
Ultrasonographic Findings
• Grayscale ultrasound
DIFFERENTIAL DIAGNOSIS
Pancreatic Ductal Carcinoma
PATHOLOGY
General Features
• Etiology
Chronic pancreatitis most commonly caused by alcohol abuse (∼ 75% of cases in USA)

– Persistent, heavy alcohol consumption for > 10 years usually required to develop chronic pancreatitis
– Other causes include idiopathic (10-30% of cases), hereditary pancreatitis, tropical pancreatitis, autoimmune pancreatitis, and systemic diseases (most notably cystic fibrosis)
CLINICAL ISSUES
Presentation
• Most common signs/symptoms
Treatment
• Most patients treated with pain management, lifestyle modification (cessation of alcohol and smoking, frequent small meals), and pancreatic enzyme replacement























































