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Pankreatitis

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Pancreatitis

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Zusammenfassung

Hintergrund

Akute und chronische Pankreatitis sind in der westlichen Welt zunehmende schwere Krankheitsbilder mit tiefgreifenden Konsequenzen für den einzelnen Patienten sowie sozioökonomisch. Der Beitrag radiologischer Bildgebung zur Diagnostik und Therapie beider Erkrankungsformen soll im vorliegenden Übersichtsbeitrag diskutiert werden.

Ergebnisse

Die akute Pankreatitis kann in eine schwere (20 %) und milde Verlaufsform unterteilt werden. Lediglich bei den schweren Formen sollte eine CT- oder MRT-Diagnostik bzgl. der Beurteilung von Nekrosen und möglichen Infektionen erfolgen. Bei der chronischen Pankreatitis genügt zunächst eine Beurteilung des Pankreas durch transabdominellen Ultraschall. Hier sind die MRT mit der Magnetresonanzcholangiopankreatikographie (MRCP) sowie die endosonographisch gesteuerte Feinnadelpunktion die Methode, um differenzialdiagnostisch die chronische Pankreatitis von Pankreaskarzinomen zu unterscheiden.

Schlussfolgerungen

Zur primären Diagnostik bei akuter und chronischer Pankreatitis sollte radiologisch nach sonographischer Abklärung ggf. weitere Diagnostik mit CT und MRT mit MRCP erfolgen.

Abstract

Background

Acute and chronic pancreatitis are becoming increasingly more severe diseases in the western world with far-reaching consequences for the individual patient as well as the socioeconomic situation. This article gives an overview of the contribution of radiological imaging to the diagnostics and therapy of both forms of the disease.

Results

Acute pancreatitis can be subdivided into severe (20 %) and mild manifestations. The diagnostics should be performed with computed tomography (CT) or magnetic resonance imaging (MRI) for assessing necrosis or potential infections only in severe forms of pancreatitis. In chronic pancreatitis transabdominal ultrasound should initially be adequate for assessment of the pancreas. For the differential diagnosis between pancreatic carcinoma and chronic pancreatitis, MRI with magnetic resonance cholangiopancreatography (MRCP) followed by an endoscopic ultrasound-guided fine needle aspiration is the method of choice.

Conclusion

For the primary diagnosis for acute and chronic pancreatitis ultrasound examination is the modality of first choice followed by radiological CT and MRI with MRCP examinations.

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Authors and Affiliations

  1. Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    A. G. Schreyer

  2. Diagnostik München, MVZ Radiologie, Augustenstraße, München, Deutschland

    L. Grenacher

  3. Diagnostische und Interventionelle Radiologie, Klinikum Konstanz, Konstanz, Deutschland

    M. Juchems

Authors
  1. A. G. Schreyer
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  2. L. Grenacher
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  3. M. Juchems
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Correspondence to A. G. Schreyer.

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Interessenkonflikt

A.G. Schreyer, L. Grenacher und M. Juchems geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Schreyer, A.G., Grenacher, L. & Juchems, M. Pankreatitis. Radiologe 56, 355–362 (2016). https://doi.org/10.1007/s00117-016-0088-8

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