Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP

Carbognin, Giovanni; Girardi, V.; Biasiutti, Carlo; Camera, Lucia; Manfredi, Riccardo; Frulloni, Luca; Hermans, John J.; Mucelli, Roberto Pozzi

doi:10.1007/s11547-009-0452-0

Cited by 67 publications

(42 citation statements)

References 35 publications

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“…When the pancreatic head is involved, narrowing of the intrapancreatic portion of the common bile duct typically is seen (Figs 6, 10). The main pancreatic duct typically is narrow and irregular in the segments affected by autoimmune pancreatitis, a finding that may be demonstrated at ERCP or MRCP (Figs 6, 10, 11) (30,41,(46)(47)(48). Occasionally, peripancreatic lymphadenopathy is seen; however, pancreatic calcifications and pseudocyst formation, which are frequently seen in patients with chronic alcoholic pancreatitis, are rare (49,50).…”

Section: Autoimmune Pancreatitismentioning

confidence: 97%

IgG4-related Sclerosing Disease: Autoimmune Pancreatitis and Extrapancreatic Manifestations

Vlachou

Khalili²,

Jang³

et al. 2011

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Autoimmune pancreatitis is the pancreatic manifestation of IgG4-related sclerosing disease, which recently was recognized as a distinct disease entity. Numerous extrapancreatic organs, such as the bile ducts, gallbladder, kidneys, retroperitoneum, thyroid, salivary glands, lung, mediastinum, lymph nodes, and prostate may be involved, either synchronously or metachronously. Most cases of autoimmune pancreatitis are associated with elevated serum IgG4 levels; extensive IgG4-positive plasma cells; and infiltration of lymphocytes into various organs, which leads to fibrosis. There are several established diagnostic criteria systems that are used to diagnose autoimmune pancreatitis and that rely on a combination of imaging findings of the pancreas and other organs, serologic findings, pancreatic histologic findings, and response to corticosteroid therapy. It is important to recognize multiorgan involvement of IgG4-related sclerosing disease and be familiar with its clinical and imaging features because it demonstrates a favorable response to treatment.

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Section: Autoimmune Pancreatitismentioning

confidence: 97%

IgG4-related Sclerosing Disease: Autoimmune Pancreatitis and Extrapancreatic Manifestations

Vlachou

Khalili²,

Jang³

et al. 2011

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“…On imaging, AIP patients can display an enlarged pancreas with swelling focused mainly around the head. This can cause diffuse narrowing of the main pancreatic duct and can also be accompanied with full dilatation of the duct and the distal bile duct [6][7][8]. Histologically, patients with AIP exhibit dense lymphoplasmacytic infiltration with fibrosis particularly concentrated around the pancreatic ducts.…”

Section: Introductionmentioning

confidence: 99%

The diagnostic significance of serum IgG4 levels in patients with autoimmune pancreatitis

Sadler

Chapman²,

Simpson³

et al. 2011

European Journal of Gastroenterology &Amp; Hepatology

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“…MRI too demonstrates the diffuse expansion of the pancreas with diminished signal intensity on T1-and increased signal intensity on T2-weighted images and a hypointense capsulelike rim. Duct penetrating sign is seen on secretin-MRCP [14]. Currently, no single serologic abnormality is diagnostic of AIP but raised serum IgG4 is a characteristic feature of AIP and a cut-off value of IgG4 > 140 mg/dl has a sensitivity of 76% and specificity of 93% [15][16].…”

Section: Discussionmentioning

confidence: 99%

Autoimmune pancreatitis : An entity difficult to diagnose

Kuntal¹,

Nangarwal²,

Meel³

et al. 2017

Int J Surg Med

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Background: Autoimmune pancreatitis is a sclerosing disorder characterized by autoimmune serology and multiple organ involvements, considered a disease of the western world, but now its incidence in India is rising because of increased awareness and development of clinicoradiological criteria to diagnose it. Case summary: A 60-years-old lady presented with pain abdomen, loss of weight, yellowish discolouration of skin and eyes. Her biochemical investigations revealed deranged liver function tests and raised erythrocyte sedimentation rate. Subsequent imaging showed bulky pancreatic head and an ill-defined hypodense mass lesion in it causing bi-lobar intrahepatic biliary dilatation. Based on the pre-operative diagnosis of carcinoma head of pancreas she underwent Whipple's procedure. To our surprise, histopathological examination confirmed this as autoimmune pancreatitis. Conclusion: Inflammatory pseudotumors have frequently been mistaken as pancreatic tumours and resected surgically. Since autoimmune pancreatitis responds dramatically to steroid therapy, accurate diagnosis can avoid major surgical undertakings like pancreatic resection.

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Autoimmune pancreatitis: imaging findings on contrast-enhanced MR, MRCP and dynamic secretin-enhanced MRCP

Abstract: Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma.

Cited by 67 publications

References 35 publications

IgG4-related Sclerosing Disease: Autoimmune Pancreatitis and Extrapancreatic Manifestations

IgG4-related Sclerosing Disease: Autoimmune Pancreatitis and Extrapancreatic Manifestations

The diagnostic significance of serum IgG4 levels in patients with autoimmune pancreatitis

Autoimmune pancreatitis : An entity difficult to diagnose

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