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CEUS Pancreas: Pancreatitis
Adrian Săftoiu, MD, PhD, MSc, FASGE; Zeno Spârchez, MD, PhD; Andrej Lyshchik, MD, PhD
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KEY FACTS

  • Clinical Implications

    • Imaging

      TERMINOLOGY

      • Definitions

        • Acute pancreatitis is acute inflammatory process of pancreas
          • As mortality rate of severe acute pancreatitis may reach up to 50%, early diagnosis and evaluation of disease severity is crucial in patient management
        • Acute pancreatitis is subdivided into 2 types
          • Interstitial edematous pancreatitis
          • Necrotizing pancreatitis
        • Chronic pancreatitis is characterized by progressive inflammatory process that involves pancreas and leads to irreversible morphologic and functional destruction of pancreas
          • Long-term consequence is exocrine and endocrine failure caused by destruction of functioning pancreatic parenchyma, which is progressively replaced by fibrous tissue
        • Autoimmune pancreatitis is form of chronic pancreatitis, which represents chronic fibroinflammatory disorder characterized by obstructive jaundice and dramatic response to steroids, in presence or absence of focal pancreatic mass

      CLINICAL IMPLICATIONS

      • Diagnosis of Pancreatitis

        • Complications of Pancreatitis

          CEUS TECHNIQUE

          • CEUS Imaging of Pancreas

            Imaging

            • Acute Pancreatitis

              • Pancreatic and Peripancreatic Collections

                • Mass-Forming Chronic Pancreatitis

                  • Autoimmune Pancreatitis

                    • Vascular Complications of Pancreatitis

                      Selected References

                      1. Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (short version). Ultraschall Med. 39(2):154-180, 2018
                      2. Fei Y et al: Effectiveness of contrast-enhanced ultrasound for the diagnosis of acute pancreatitis: A systematic review and meta-analysis. Dig Liver Dis. 49(6):623-629, 2017
                      3. Bhutani MS et al. Fast Facts: Pancreas and Biliary Diseases. Health Press Limited, United Kingdom, 2017
                      4. Fusaroli P et al: The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence. Gastrointest Endosc. 84(4):587-596.e10, 2016
                      5. Cai DM et al: Diagnostic value of contrast enhanced ultrasound for splenic artery complications following acute pancreatitis. World J Gastroenterol. 20(4):1088-94, 2014
                      6. Crosara S et al: Autoimmune pancreatitis: Multimodality non-invasive imaging diagnosis. World J Gastroenterol. 20(45):16881-90, 2014
                      7. Ripollés T et al: Contrast-enhanced ultrasound in the staging of acute pancreatitis. Eur Radiol. 20(10):2518-23, 2010
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Clinical Implications

                        • Imaging

                          TERMINOLOGY

                          • Definitions

                            • Acute pancreatitis is acute inflammatory process of pancreas
                              • As mortality rate of severe acute pancreatitis may reach up to 50%, early diagnosis and evaluation of disease severity is crucial in patient management
                            • Acute pancreatitis is subdivided into 2 types
                              • Interstitial edematous pancreatitis
                              • Necrotizing pancreatitis
                            • Chronic pancreatitis is characterized by progressive inflammatory process that involves pancreas and leads to irreversible morphologic and functional destruction of pancreas
                              • Long-term consequence is exocrine and endocrine failure caused by destruction of functioning pancreatic parenchyma, which is progressively replaced by fibrous tissue
                            • Autoimmune pancreatitis is form of chronic pancreatitis, which represents chronic fibroinflammatory disorder characterized by obstructive jaundice and dramatic response to steroids, in presence or absence of focal pancreatic mass

                          CLINICAL IMPLICATIONS

                          • Diagnosis of Pancreatitis

                            • Complications of Pancreatitis

                              CEUS TECHNIQUE

                              • CEUS Imaging of Pancreas

                                Imaging

                                • Acute Pancreatitis

                                  • Pancreatic and Peripancreatic Collections

                                    • Mass-Forming Chronic Pancreatitis

                                      • Autoimmune Pancreatitis

                                        • Vascular Complications of Pancreatitis

                                          Selected References

                                          1. Sidhu PS et al: The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (short version). Ultraschall Med. 39(2):154-180, 2018
                                          2. Fei Y et al: Effectiveness of contrast-enhanced ultrasound for the diagnosis of acute pancreatitis: A systematic review and meta-analysis. Dig Liver Dis. 49(6):623-629, 2017
                                          3. Bhutani MS et al. Fast Facts: Pancreas and Biliary Diseases. Health Press Limited, United Kingdom, 2017
                                          4. Fusaroli P et al: The clinical impact of ultrasound contrast agents in EUS: a systematic review according to the levels of evidence. Gastrointest Endosc. 84(4):587-596.e10, 2016
                                          5. Cai DM et al: Diagnostic value of contrast enhanced ultrasound for splenic artery complications following acute pancreatitis. World J Gastroenterol. 20(4):1088-94, 2014
                                          6. Crosara S et al: Autoimmune pancreatitis: Multimodality non-invasive imaging diagnosis. World J Gastroenterol. 20(45):16881-90, 2014
                                          7. Ripollés T et al: Contrast-enhanced ultrasound in the staging of acute pancreatitis. Eur Radiol. 20(10):2518-23, 2010