pancreatic radiology

PANCREAS

1.ACUTE PANCREATITIS

USG :

SWOLLEN AND HYPOECHOIC PANCREAS

CT – CONTRAST ENHANCED

1.SWOLLEN

2.PERIPANCREATIC FAT STRANDING – HYPERATTENUATING STRANDS AROUND PANCREAS

3.PERIPANCREATIC FLUID – HYPOATTENUATION WITH WATER DENSITY AROUND PANCREAS

4.PANCREATIC NECROSIS – NON ENHANCEMENT INSIDE THE PANCREAS

5.PANCREATIC ABSCESS – PRESENCE OF AIR IN THE PARENCHYMA

6.PANCREATIC HEMORRAHGE – ASSOCIATED WITH PANCREATIC NECROSIS – HYPERATTENUATION INSIDE THE NON ENHANCING PARENCHYMA

7.SPLENIC VEIN ANEURYSM – SPLENIC VEIN MAY SHOW AREAS OF FOCAL ENLARGEMENT

8.PSEUDOCYST – FORMS AFTER 6 WEEKS BALTHAZAAR GRADING OF ACUTE PANCREATITISA.NORMALB.ENLARGEMENTC.PANCREATIC INFLAMMATIOND.SINGLE POCKET FLUID COLLECTIONE. MULTIPLE POCKETS OF FLUID COLLECTION

X – RAY -NOT USEFUL

1.SENTINAL LOOP 2.COLON CUT OFF 3.ILEUS

2.CHRONIC PANCREATITIS

USG:

1.HYPER ECHOIC 2.DILATED DUCT3.NORMAL OR DECRESED SIZE4.AREAS OF CALCIFICATION SHOW HYPERECHOIC FOCAL LESION WITH SHADOW

PSEUDOCYST

LONGITUDINAL SECTION THROUGH THE PANCREAS SHOWS MULTIPLE ECHOGENIC FOCAL AREAS WITHOUT SHADOWING

CT :

NON ENHANCED:

CALCIFICATION +

REVERSE 3 SIGN WITH GASTROGRAFFIN IN THE DUODENUM

CALCIFICATION +

PSEUDOCYST +

ENHANCED :

FOCAL NON CALCIFIC CHRONIC PANCREATITIS

DILATATION OF MAIN PANCREATIC DUCT

MRI:

DILATED TORTUOUS MAIN PANCREATIC DUCT

BARIUM STUDY :

REVERSE 3 SIGN SEEN WITH ENLARGED HEAD OF PANCREAS – SEEN IN CHRONIC PANCREATITIS AND CA PANCREAS

PLAIN ABDOMINAL RADIOGRAPH:

CALCIFICATION OF PANCREAS SEEN ALONG THE LENGTH OF PANCREAS

CA PANCREAS

USG :

CA HEAD OF PANCREAS WITH HYPOECHOIC AREAS IN THE HEAD AND UNCINATE PROCESS

CA TAIL OF PANCREAS HYOECHOIC FOCAL ENLARGEMENT IN THE TAIL OF THE PANCREAS

METASTATIC DEPOSITS IN TAIL OF PANCREAS

ENDOSCOPIC USG – SHOWING MASS IN

PANCREAS WITH DILATATION OF CBD AND WITHOUT INVASION OF SUPERIOR MESENTRIC VEIN AND PORTAL VEIN

CT :

MASS IN THE HEAD OF THE PANCREAS WITH SUPERIOR MESENTRIC ARTERY INVASION AND DILATATION OF GALL BLADDER

PANCREATIC MASS CAUSING DILATAION OF BOTH CBD AND PANCREATIC DUCT