Aim
To evaluate the magnetic resonance (MR) imaging-MR cholangiopancreatographic (MRCP) findings of focal forms of autoimmune pancreatitis (AIP) to describe ductal involvement at diagnosis.
BackgroundIt is essential to differentiate sclerosing cholangitis with autoimmune pancreatitis (SC-AIP) from primary sclerosing cholangitis (PSC) as the treatment and prognosis of the two diseases are totally different.PurposeTo compare image findings of SC-AIP and PSC on endoscopic retrograde cholangiography (ERC), magnetic resonance cholangiography (MRC), computed tomography (CT), and magnetic resonance imaging (MRI).Material and MethodsTwo radiologists retrospectively reviewed ERC, MRC, CT, a...
AIM: To identify the radiological characteristics of focal autoimmune pancreatitis (f-AIP) useful for differentiation from pancreatic cancer (PC). METHODS: Magnetic resonance imaging (MRI) and triple-phase computed tomography (CT) scans of 79 patients (19 with f-AIP, 30 with PC, and 30 with a normal pancreas) were evaluated retrospectively. A radiologist measured the CT attenuation of the pancreatic parenchyma, the f-AIP and PC lesions in triple phases. The mean CT attenuation values of the f-AI...
AIM: To investigate differences in clinical features between diffuse- and focal-type autoimmune pancreatitis (AIP). METHODS: Based on radiological findings by computed tomography and/or magnetic resonance imaging, we divided 67 AIP patients into diffuse type (D type) and focal type (F type). We further divided F type into head type (H type) and body and/or tail type (B/T type) according to the location of enlargement. Finally, we classified the 67 AIP patients into three groups: D type, H type a...
The authors review imaging findings of autoimmune pancreatitis, with emphasis on the extrapancreatic manifestations of IgG4-related sclerosing disease in the bile ducts, gallbladder, kidneys, retroperitoneum, thyroid, salivary glands, lung, mediastinum, lymph nodes, and prostate.
Autoimmune pancreatitis (AIP) is a well-defined clinical entity athologically different from all the other forms of chronic panreatitis. Since its first description, the concept of the disease has reatly changed over time. On the basis of pathological findings, the disease has been ecently classified in type 1 AIP (also called Lympho-Plasmacytic clerosing Pancreatitis – LPSP), and type 2 AIP (also called Idiopathic uct-centric Chronic Pancreatitis – IDCP), as reported by Matsubyashi et al. [1]. ...
MR imaging can depict pancreatic abnormalities suggestive of autoimmune pancreatitis at diagnosis and the remission of these abnormalities after steroid therapy, and the bile ducts and the kidneys also may be involved and should be assessed; during follow-up, the risk of recurrence increases with time.
Autoimmune pancreatitis (AIP) is a puzzling disease. Although its cardinal features were first reported in Europe,1 it seemed, for a long time an Asian phenomenon which many Western clinicians felt they could largely ignore.2 3 As more case series were reported from Europe and America it became increasingly clear that AIP affects patients from many ethnic backgrounds. AIP shares features with two other disorders of the pancreas from which a distinction is critical and determines appropriate trea...
Autoimmune pancreatitis is a disease characterized by specific pathological features, different from those of other forms of pancreatitis, that responds dramatically to steroid therapy. The pancreatic parenchyma may be diffusely or focally involved with the possibility of a low-density mass being present at imaging, mimicking pancreatic cancer. Clinically, the most relevant problems lie in the diagnosis of autoimmune pancreatitis and in distinguishing autoimmune pancreatitis from pancreatic canc...
PURPOSE To evaluate the diagnostic performance of the radiomics score (rad-score) for differentiating focal-type autoimmune pancreatitis (fAIP) from pancreatic ductal adenocarcinoma (PDAC). METHODS This retrospective review included 42 consecutive patients with fAIP diagnosed according to the International Consensus Diagnostic Criteria between January 2011 and December 2018. Furthermore, 334 consecutive patients with PDAC confirmed by pathology were also reviewed during the same period. Patients...
CLINICAL/METHODOLOGICAL ISSUE Chronic pancreatitis (CP) is a long-lasting inflammation of the pancreas that changes the normal structure and function of the organ. There are a wide range of inflammatory pancreatic diseases, of which some entities, such as focal pancreatitis (FP) or "mass-forming pancreatitis," can mimic pancreatic ductal adenocarcinoma (PDAC). As a consequence, a misdiagnosis can lead to avoidable and unnecessary surgery or delay of therapy. STANDARD RADIOLOGICAL METHODS The ini...
To systematically determine the diagnostic performance of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC), with a comparison between the two imaging modalities. Literature search was conducted using PubMed and EMBASE databases to identify original articles published between 2009 and 2019 reporting the diagnostic performance of CT and MRI for differentiating AIP from PDAC. The meta-analyti...
#2Max Seidensticker(LMU: Ludwig Maximilian University of Munich)H-Index: 21
Last. Julia Mayerle(LMU: Ludwig Maximilian University of Munich)H-Index: 67
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Background There is currently no S3 guideline that contains statements on the diagnosis and treatment of acute, chronic and autoimmune pancreatitis in a single guideline. Objectives This article presents the most relevant recommendations relating to radiological imaging from the new "S3 guideline for pancreatitis". Materials and methods The guideline was developed by the DGVS (German Society for Digestive and Metabolic Diseases). After an online-based Delphi survey, the statements were discussed...
PURPOSE The aim of this study was to clarify the usefulness of the apparent diffusion coefficient (ADC) value in the differential diagnosis of localized autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC) and the evaluation of response to steroids. METHODS This study retrospectively analyzed 40 patients with localized AIP and 71 patients with PDAC who underwent abdominal MRI with DWI (b = 0 and 1000 s/mm2). Their ADC values at the lesion sites and five MRI findings useful f...
Liver masses are becoming more common with the increasing application and power of imaging techniques for the evaluation of abdominal conditions. Various imaging modalities can be utilized to accurately diagnose such masses without resorting to more invasive diagnostic measures. The language of radiology is rich with descriptions of imaging findings, often metaphorical, which have found common usage in the day-to-day practice of abdominal radiology. The chapter selects classic signs accumulated ...
Last. Jun Ushio(Jichi Medical University)H-Index: 4
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Autoimmune pancreatitis (AIP) is characterized by enlargement of the pancreas and irregular narrowing of the main pancreatic duct. It is often associated with IgG4-related sclerosing cholangitis (IgG4-SC), in which the bile duct narrows. Although characteristic irregular narrowing of the pancreatic duct caused by endoscopic retrograde cholangiopancreatography is noted in AIP, it is difficult to differentiate between localized AIP and pancreatic carcinoma based on imaging of the pancreatic duct. ...
Autoimmune pancreatitis has received considerable attention, especially due to the marked effect of corticosteroid therapy on its clinical course. Knowledge, especially regarding type 1 autoimmune pancreatitis, has significantly increased over the last decades, and despite significant differences in pathophysiology and outcomes, both type 1 and 2 autoimmune pancreatitis are still considered different types of the same disease. Some have proposed a different nomenclature reflecting these differen...
#1J-Matthias Löhr(Karolinska University Hospital)H-Index: 11
#2Ulrich Beuers(UvA: University of Amsterdam)H-Index: 78
Last. Heiko Witt(TUM: Technische Universität München)H-Index: 44
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The overall objective of these guidelines is to provide evidence-based recommendations for the diagnosis and management of immunoglobulin G4 (IgG4)-related digestive disease in adults and children. IgG4-related digestive disease can be diagnosed only with a comprehensive work-up that includes histology, organ morphology at imaging, serology, search for other organ involvement, and response to glucocorticoid treatment. Indications for treatment are symptomatic patients with obstructive jaundice, ...