Skip to main content

Imaging Findings: CT and MRI with MRCP

  • Chapter
  • First Online:
Autoimmune Pancreatitis

Abstract

Autoimmune pancreatitis has a wide range of possible imaging features, and there are overlaps in appearance with other pancreatic diseases. However, in the diagnosis of autoimmune pancreatitis, imaging findings are important components of diagnostic criteria and should be considered in conjunction with the clinical, serologic, and pathological findings. Imaging methods employed in the diagnosis and treatment response evaluation of autoimmune pancreatitis include computed tomography (CT), magnetic resonance imaging (MRI), transabdominal ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasonography (EUS) [1–4]. Here we focus on typical and atypical findings of autoimmune pancreatitis in CT, MRI, and MRCP and the differential points with other diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Finkelberg DL, Sahani D, Deshpande V, Brugge WR. Autoimmune pancreatitis. N Engl J Med. 2006;355(25):2670–6.

    Article  CAS  PubMed  Google Scholar 

  2. Suzuki K, Itoh S, Nagasaka T, Ogawa H, Ota T, Naganawa S. CT findings in autoimmune pancreatitis: assessment using multiphase contrast-enhanced multisection CT. Clin Radiol. 2010;65(9):735–43.

    Article  CAS  PubMed  Google Scholar 

  3. Sahani DV, Kalva SP, Farrell J, et al. Autoimmune pancreatitis: imaging features. Radiology. 2004;233(2):345–52.

    Article  PubMed  Google Scholar 

  4. Okazaki K, Kawa S, Kamisawa T, et al. Japanese consensus guidelines for management of autoimmune pancreatitis: I. Concept and diagnosis of autoimmune pancreatitis. J Gastroenterol. 2010;45(3):249–65.

    Article  PubMed  Google Scholar 

  5. Shanbhogue AK, Fasih N, Surabhi VR, Doherty GP, Shanbhogue DK, Sethi SK. A clinical and radiologic review of uncommon types and causes of pancreatitis. Radiographics. 2009;29(4):1003–26.

    Article  PubMed  Google Scholar 

  6. Kawamoto S, Siegelman SS, Hruban RH, Fishman EK. Lymphoplasmacytic sclerosing pancreatitis (autoimmune pancreatitis): evaluation with multidetector CT. Radiographics. 2008;28(1):157–70.

    Article  PubMed  Google Scholar 

  7. Shimosegawa T, Chari ST, Frulloni L, et al. International consensus diagnostic criteria for autoimmune pancreatitis: guidelines of the International Association of Pancreatology. Pancreas. 2011;40(3):352–8.

    Article  PubMed  Google Scholar 

  8. Takahashi N, Fletcher JG, Hough DM, et al. Autoimmune pancreatitis: differentiation from pancreatic carcinoma and normal pancreas on the basis of enhancement characteristics at dual-phase CT. AJR Am J Roentgenol. 2009;193(2):479–84.

    Article  PubMed  Google Scholar 

  9. Ishigami K, Tajima T, Nishie A, et al. MRI findings of pancreatic lymphoma and autoimmune pancreatitis: a comparative study. Eur J Radiol. 2010;74(3):e22–8.

    Article  PubMed  Google Scholar 

  10. Kwak SW, Kim S, Lee JW, et al. Evaluation of unusual causes of pancreatitis: role of cross-sectional imaging. Eur J Radiol. 2009;71(2):296–312.

    Article  PubMed  Google Scholar 

  11. Kamisawa T, Tu Y, Egawa N, et al. Can MRCP replace ERCP for the diagnosis of autoimmune pancreatitis? Abdom Imaging. 2009;34(3):381–4.

    Article  CAS  PubMed  Google Scholar 

  12. Park SH, Kim MH, Kim SY, et al. Magnetic resonance cholangiopancreatography for the diagnostic evaluation of autoimmune pancreatitis. Pancreas. 2010;39(8):1191–8.

    Article  PubMed  Google Scholar 

  13. Kamisawa T, Yoshiike M, Egawa N, et al. Chronic pancreatitis in the elderly in Japan. Pancreatology. 2004;4(3–4):223–7; discussion 227–8.

    Article  PubMed  Google Scholar 

  14. Zhang L, Chari S, Smyrk TC, et al. Autoimmune pancreatitis (AIP) type 1 and type 2: an international consensus study on histopathologic diagnostic criteria. Pancreas. 2011;40(8):1172–9.

    Article  CAS  PubMed  Google Scholar 

  15. Divatia M, Kim SA, Ro JY. IgG4-related sclerosing disease, an emerging entity: a review of a multi-system disease. Yonsei Med J. 2012;53(1):15–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Kim JH, Kim MH, Byun JH, et al. Diagnostic strategy for differentiating autoimmune pancreatitis from pancreatic cancer: is an endoscopic retrograde pancreatography essential? Pancreas. 2012;41:639–647

    Google Scholar 

  17. Taniguchi T, Kobayashi H, Nishikawa K, et al. Diffusion-weighted magnetic resonance imaging in autoimmune pancreatitis. Jpn J Radiol. 2009;27(3):138–42.

    Article  PubMed  Google Scholar 

  18. Kamisawa T, Takuma K, Anjiki H, et al. Differentiation of autoimmune pancreatitis from pancreatic cancer by diffusion-weighted MRI. Am J Gastroenterol. 2010;105(8):1870–5.

    Article  PubMed  Google Scholar 

  19. Loos M, Esposito I, Hedderich DM, et al. Autoimmune pancreatitis complicated by carcinoma of the pancreatobiliary system: a case report and review of the literature. Pancreas. 2011;40(1):151–4.

    Article  PubMed  Google Scholar 

  20. Takuma K, Kamisawa T, Tabata T, Inaba Y, Egawa N, Igarashi Y. Short-term and long-term outcomes of autoimmune pancreatitis. Eur J Gastroenterol Hepatol. 2011;23(2):146–52.

    Article  CAS  PubMed  Google Scholar 

  21. Vlachou PA, Khalili K, Jang HJ, Fischer S, Hirschfield GM, Kim TK. IgG4-related sclerosing disease: autoimmune pancreatitis and extrapancreatic manifestations. Radiographics. 2011;31(5):1379–402.

    Article  PubMed  Google Scholar 

  22. Welsch T, Kleeff J, Esposito I, Buchler MW, Friess H. Autoimmune pancreatitis associated with a large pancreatic pseudocyst. World J Gastroenterol. 2006;12(36):5904–6.

    PubMed Central  PubMed  Google Scholar 

  23. Gouyon B, Levy P, Ruszniewski P, et al. Predictive factors in the outcome of pseudocysts complicating alcoholic chronic pancreatitis. Gut. 1997;41(6):821–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Miller FH, Rini NJ, Keppke AL. MRI of adenocarcinoma of the pancreas. AJR Am J Roentgenol. 2006;187(4):W365–74.

    Article  PubMed  Google Scholar 

  25. Church NI, Pereira SP, Deheragoda MG, et al. Autoimmune pancreatitis: clinical and radiological features and objective response to steroid therapy in a UK series. Am J Gastroenterol. 2007;102(11):2417–25.

    Article  CAS  PubMed  Google Scholar 

  26. Ghazale A, Chari ST, Zhang L, et al. Immunoglobulin G4-associated cholangitis: clinical profile and response to therapy. Gastroenterology. 2008;134(3):706–15.

    Article  PubMed  Google Scholar 

  27. Sohn JH, Byun JH, Yoon SE, et al. Abdominal extrapancreatic lesions associated with autoimmune pancreatitis: radiological findings and changes after therapy. Eur J Radiol. 2008;67(3):497–507.

    Article  PubMed  Google Scholar 

  28. Nakazawa T, Ohara H, Sano H, et al. Cholangiography can discriminate sclerosing cholangitis with autoimmune pancreatitis from primary sclerosing cholangitis. Gastrointest Endosc. 2004;60(6):937–44.

    Article  PubMed  Google Scholar 

  29. Nishino T, Toki F, Oyama H, et al. Biliary tract involvement in autoimmune pancreatitis. Pancreas. 2005;30(1):76–82.

    PubMed  Google Scholar 

  30. Kamisawa T, Egawa N, Nakajima H, Tsuruta K, Okamoto A. Extrapancreatic lesions in autoimmune pancreatitis. J Clin Gastroenterol. 2005;39(10):904–7.

    Article  PubMed  Google Scholar 

  31. Bodily KD, Takahashi N, Fletcher JG, et al. Autoimmune pancreatitis: pancreatic and extrapancreatic imaging findings. AJR Am J Roentgenol. 2009;192(2):431–7.

    Article  PubMed  Google Scholar 

  32. Kim JH, Byun JH, Kim SY, et al. Sclerosing cholangitis with autoimmune pancreatitis versus primary sclerosing cholangitis: comparison on endoscopic retrograde cholangiography, MR cholangiography, CT, and MRI. Acta Radiol. 2013;54(6):601–7.

    Article  PubMed  Google Scholar 

  33. Kim JH, Byun JH, Lee SJ, et al. Differential diagnosis of sclerosing cholangitis with autoimmune pancreatitis and periductal infiltrating cancer in the common bile duct at dynamic CT, endoscopic retrograde cholangiography and MR cholangiography. Eur Radiol. 2012;22(11):2502–13.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Min Jung Park MD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Park, M.J., Chung, Y.E., Park, MS. (2015). Imaging Findings: CT and MRI with MRCP. In: Kamisawa, T., Chung, J. (eds) Autoimmune Pancreatitis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55086-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-55086-7_11

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-55085-0

  • Online ISBN: 978-3-642-55086-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics