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30 Cards in this Set
- Front
- Back
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What are the most important goals of imaging studies in pancratitis?
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Detect complications
Stage severity |
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What are other goals of imaging?
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Confirm diagnosis if uncertainty.
Identify cause (if possible) |
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Ultrasound appearance of pancreatitis?
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Enlargement of pancreas
Decreased echogenicity, relative to liver |
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What do focal areas of hypoechogenicity indicate?
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Fluid or severe inflammation
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What do focal areas of hyperechogenicity indicate?
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Hemorrhage
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What is the most important complication of pancreatitis to be identified on imaging?
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Necrosis
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How is pancreatic necrosis best identified?
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CT
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CT findings of pancreatitis?
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Enlargement of gland
Indistinct borders Peripancreatic inflammation and fluid Evidence of necrosis and hemorrhage. |
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How does necrosis appear?
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Hypodense, poor enhancement
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How does hemorrhage appear
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Hyperdense areas
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What is another modality used to evaluate pancreatitis?
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MR
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What sequences are used in MRCP?
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RARE
HASTE/SSFSE |
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What is RARE
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Thick slap acquisition
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What is HASTE/SSFSE
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Thin slice T2 weighted image
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What are some of the nonbiliary and non EtOH causes of pancreatitis?
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Trauma.
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What is key to look for in pancreatitis related to trauma?
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Look for laceration in addition to the other signs
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What is prognosis of traumatic versus other causes of pancreatitis?
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Worse
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What is the next most common cause of pancreatitis?
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Ductal anomalies
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Which ductal anomaly is most common?
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Pancreas divisum
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How common is pancreas divisium?
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At least 5% of general population
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What is cause of pancreas divisum?
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Failure of dorsal and ventral anlages of pancreas to fuse
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Where to the anlages originate?
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Duodenum
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Which is larger?
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Dorsal
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Which is located more caudally?
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Ventral
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What is different about the parenchyma of the dorsal and ventral anlages?
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Ventral is rich in polypeptides, dorsal is poor in polypeptides. This is why dorsal anlage is prone to atrophy, but ventral pancreas is not.
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What is embryologic drainage pattern?
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Dorsal anlage drains via its long duct into the duodenum. Ventral anlage drains via its short duct into duodenum.
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Whose duct inserts where?
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Dorsal duct inserts higher in the medial wall of the descending duodenum than the ventral duct does.
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What happens in the normal case to form normal pancreatic ductal anatomy?
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Dorsal duct becomes connected to the ventral, and the new duct drains through the ventral duct's opening.
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What is this new duct called?
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Wirsung
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Where does Wirsung drain?
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Major papilla (ampulla of Vater)
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