Urograffin had been used to opacify the bile and the pancreatic duct
. For the current study, successful stent retrieval was defined as complete removal of stent or where the distal tip of the stent was left in the duodenum.7 Proximal CBD migration was defined as when the lower end of the migrated stent was present above the cystic duct in the CBD.
Intraductal solid tumor within the main (n=7) or branch (n=1) pancreatic duct
was detected in 62.5% of cases with CT (5 of 8), 71.4% with MRCP (5 of 7), and 100% with EUS (7 of 7).
EUS-guided rendezvous drainage for pancreatic duct
obstruction from stenosis of pancreatojejunal anastomosis after pancreatoduodenostomy.
In the group of 70 patients, the following lesions were found: normal pancreatic ducts
were observed in 35 patients, PanIN 1A in 65 patients, PanIN 1B in 67 patients, PanIN 2 in 51 patients and only 21 patients had PanIN 3 (Table 2).
(1) Intraductal tubulopapillary neoplasm shows solid and nodular masses occluding the pancreatic duct
without mucin production, whereas IPMN shows polypoid tumors as mural nodules intruding into dilated duct with prominent cystic changes and visible mucin.
Pancreatic carcinoma was diagnosed on the basis of one of the following (1) ill-defined hypoechoic mass having reduced vascularity on Doppler in comparison with normal pancreatic parenchyma, with dilated common bile duct (CBD) and/or pancreatic duct
US can present the diffuse enlargement and hypoechoic pancreas, but it cannot show the irregular narrowing or stenosis of the pancreatic duct
. Quantitative perfusion analysis in pancreatic contrast enhanced ultrasound (DCE-US) can show the vascular lesions of pancreas and play a significant role in differentiating AIP from pancreatic cancer .
Finally, the ventral and dorsal pancreatic ducts
fuse, and the pancreas is predominantly drained through the ventral duct, which joins the Common Bile Duct (CBD] at the level of the major papilla.
Rege and Moore found that the acidification of bile is a major factor in the development of gallbladder stones, which have been documented to block the bile and pancreatic ducts
and severely damage the liver and pancreas.
Secretin MRCP (s-MRCP), a dynamic MR pancreatography exam performed following secretin administration, can overcome many of these limitations by improving visualization of the pancreatic duct
and increasing the diagnostic value of MRCP.
The latter is caused by a blockage of the bile and pancreatic ducts
with calcified lumps of bile.
This study did not evaluate MRCP or US (EUS) findings, so the probable CP criteria imaging findings using these modalities were excluded, namely, "(a) irregular dilatation of the MPD and irregular dilatation of pancreatic duct
branches of variable intensity with scattered distribution throughout the entire pancreas on MRCP" and "(d) intra-pancreatic coarse hyperreflectivities suggestive of stones or protein plugs or irregular dilatation of pancreatic ducts
plus pancreatic deformity with irregular contour on US (EUS)."