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Abdominal Imaging

, Volume 34, Issue 3, pp 381–384 | Cite as

Can MRCP replace ERCP for the diagnosis of autoimmune pancreatitis?

  • T. Kamisawa
  • Y. Tu
  • N. Egawa
  • K. Tsuruta
  • A. Okamoto
  • M. Kodama
  • N. Kamata
Article

Abstract

Background

It is of utmost importance that autoimmune pancreatitis (AIP) be differentiated from pancreatic cancer. Irregular narrowing of the main pancreatic duct is a characteristic finding in AIP; it is useful for differentiating AIP from pancreatic cancer stenosis. This study evaluated the usefulness of magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of AIP and assessed whether MRCP could replace endoscopic retrograde cholangiopancreatography (ERCP) for diagnosing AIP.

Methods

The MRCP and ERCP findings of 20 AIP patients were compared.

Results

On MRCP, the narrowed portion of the main pancreatic duct was not visualized, while the noninvolved segments of the pancreatic duct were visualized. The degree of upstream dilatation of the proximal main pancreatic duct was milder in AIP than in pancreatic cancer patients. In the skipped type, only skipped narrowed lesions were not visualized. After steroid therapy for AIP, the nonvisualized main pancreatic duct became visualized.

Conclusions

MRCP cannot replace ERCP for the diagnosis of AIP, since narrowing of the main pancreatic duct in AIP was not visualized on MRCP. MRCP findings of segmental or skipped nonvisualized main pancreatic duct accompanied by a less dilated upstream main pancreatic duct may suggest the presence of AIP. MRCP is useful for following AIP patients.

Keywords

Autoimmune pancreatitis Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography Pancreatic cancer Main pancreatic duct 

Notes

Acknowledgment

This study was supported by Research for Intractable Disease of the Pancreas, Minister of Labor and Welfare of Japan.

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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • T. Kamisawa
    • 1
  • Y. Tu
    • 1
  • N. Egawa
    • 1
  • K. Tsuruta
    • 2
  • A. Okamoto
    • 2
  • M. Kodama
    • 3
  • N. Kamata
    • 3
  1. 1.Department of Internal MedicineTokyo Metropolitan Komagome HospitalTokyoJapan
  2. 2.Department of SurgeryTokyo Metropolitan Komagome HospitalTokyoJapan
  3. 3.Department of RadiologyTokyo Metropolitan Komagome HospitalTokyoJapan

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