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World J Gastroenterol. Nov 14, 2013; 19(42): 7241-7246
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7241
Morphological and functional evaluation of chronic pancreatitis with magnetic resonance imaging
Tine Maria Hansen, Matias Nilsson, Mikkel Gram, Jens Brøndum Frøkjær
Tine Maria Hansen, Jens Brøndum Frøkjær, Mech-Sense, Department of Radiology, Aalborg University Hospital, 9000 Aalborg, Denmark
Matias Nilsson, Mikkel Gram, Mech-Sense, Department of Gastroenterology, Aalborg University Hospital, 9000 Aalborg, Denmark
Author contributions: Hansen TM, Nilsson M, Gram M and Frøkjær JB contributed equally to this review.
Supported by The Danish Council for Strategic Research
Correspondence to: Jens Brøndum Frøkjær, MD, PhD, Mech-Sense, Department of Radiology, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark. jf@mech-sense.com
Telephone: +45-9932-6825 Fax: +45-9932-6507
Received: June 12, 2013
Revised: July 13, 2013
Accepted: August 5, 2013
Published online: November 14, 2013
Abstract

Magnetic resonance imaging (MRI) techniques for assessment of morphology and function of the pancreas have been improved dramatically the recent years and MRI is very often used in diagnosing and follow-up of chronic pancreatitis (CP) patients. Standard MRI including fat-suppressed T1-weighted and T2-weighted imaging techniques reveal decreased signal and glandular atrophy of the pancreas in CP. In contrast-enhanced MRI of the pancreas in CP the pancreatic signal is usually reduced and delayed due to decreased perfusion as a result of chronic inflammation and fibrosis. Thus, morphological changes of the ductal system can be assessed by magnetic resonance cholangiopancreatography (MRCP). Furthermore, secretin-stimulated MRCP is a valuable technique to evaluate side branch pathology and the exocrine function of the pancreas and diffusion weighted imaging can be used to quantify both parenchymal fibrotic changes and the exocrine function of the pancreas. These standard and advanced MRI techniques are supplementary techniques to reveal morphological and functional changes of the pancreas in CP. Recently, spectroscopy has been used for assessment of metabolite concentrations in-vivo in different tissues and may have the potential to offer better tissue characterization of the pancreas. Hence, the purpose of the present review is to provide an update on standard and advanced MRI techniques of the pancreas in CP.

Keywords: Magnetic resonance, Chronic pancreatitis, Secretin, Diffusion weighted imaging, Exocrine pancreatic function

Core tip: Magnetic resonance imaging (MRI) techniques for assessment of morphology and function of the pancreas are often used in diagnosing and follow-up of chronic pancreatitis patients. The purpose of the present review is to provide an update on standard and advanced MRI techniques of the pancreas in chronic pancreatitis. In addition to standard MRI techniques, advanced MRI techniques including magnetic resonance cholangiopancreatography (MRCP), secretin-stimulated MRCP and diffusion weighted imaging can also provide important microstructural and functional information.