MDCT Imaging Features of Acute and Chronic Pancreatitis with its Complications: A Pictorial Review

Abstract

The incidence of Acute Pancreatitis (AP) was 30.0 per 100,000 population overall. The two most common aetiological factors of AP are gallstones and alcohol abuse, while other causes such as metabolic, iatrogenic, vascular, infections, and toxic factors are less important and less common. Two laboratory tests, serum amylase and lipase levels, which have relatively good sensitivity and specificity, complement imaging in the diagnosis and treatment of some cases of AP. Imaging helps confirm the clinical diagnosis, determine the cause, grade the extent of AP, and assess its severity, in addition to clinical symptoms and laboratory studies. Chronic Pancreatitis (CP) is characterised by continuous inflammatory and fibrotic changes in the pancreas, eventually resulting in exocrine and endocrine dysfunction. Alcoholism is a factor in 70-90% of CP cases. Other causes include chronic ulcerative colitis, Sjogren’s syndrome, primary sclerosing cholangitis, etc. Early diagnosis of CP is challenging, as biochemical studies do not provide definitive diagnosis in the early stages. Imaging, mainly Contrast Enhanced Computed Tomography (CECT) and Magnetic Resonance Imaging (MRI), aids in the definitive diagnosis. The present pictorial article aimed to provide an image-rich overview of the morphological features associated with the early-stage and late-stage local consequences of acute and chronic pancreatitis.

Keywords

• aneurysm
• emphysematous
• fat stranding
• fluid collection
• multidetector computed tomography
• necrosis
• oedema
• pancreas
• thrombosis