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What Does This MRCP Report Indicate?
Question: Hello doctor
I was diagnosed with developing chronic pancreatitis last year based on EUS symptoms like Hyperechoic foci, strands and lobulations, cyst , and dialated pancreatic duct of 3mm in body region. There was no pain or calcification or stone or strictures. i was also bit diabetic. Now after 1 year i started having having oily stools after oily food one day. this process continued for few days and i started getting oily stools on and off after some oily or heavy food. My doctor given me pancreatitic enzymes creon. I have also lost 2 kg weight in last 2 months. MY gall bladder was also removed last year.
I have gone through MRCP today and report of MRCP is as below :-
DEPARTMENT OF RADIODIAGNOSIS AND IMAGING
Patient Name
: XXXXXXX XXXX
Procedure Date
: 12/09/2015
UHID
: JHN0000
Order From
: RADIOLOGY-BILL-GF-AB
Age/Sex
: 35Y/M
Accession No.
: SC115MR0000
Requested By
: DR. XXXXXXX XXXX
Investigation
: MRCP
Ordered Time
: 12/09/2015
Reported Time
: 12-9-2015 10:43:49
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY
PROCEDURE
MRCP was performed on 3 Tesla scanner using heavily T2 weighted sequences in coronal and oblique coronal planes. T1 as well as T2 weighted images were also obtained through the liver and pancreas.
Clinical details- Status post Cholecystectomy on ATT for periportal lymph nodes. Previous history of acute pancreatitis.
FINDINGS
Liver is normal in size and shows normal signal intensity. No focal lesion seen. The intrahepatic biliary radicals are not dilated. No SOL. Hepatic vein and portal vein seen normal.
Gall bladder is not visualised (operated).
Pancreas is atrophic with irregular dilated pancreatic duct with dilated ductules. There is a well defined cyst measuring 2.4 x 1.9 cm in pancreatic head – communicating with pancreatic duct.
Two other cysts measuring 2.6 x 1.8 & 1.5 x 1.1 cm are seen anterosuperior to pancreatic body partially within the pancreatic parenchyma. The cysts are not communicating with the pancreatic duct.
Portal & splenic veins are normal. Flow void of splenic artery is normal.
There are multiple periportal & Peripancreatic lymph nodes, largest measuring 2.3 x 1.8 cm.
MRCP-
Intrahepatic biliary radicals are normal.
CBD is normal in course and calibre ( 6.3 mm ). No intraluminal signal void/calculus in CBD.
IMPRESSION: 1. Chronic pancreatitis with pseudocysts
2. Multiple periportal & Peripancreatic lymph nodes.
Dr. XXXXXXX Garg
MD,DNB
Sr. Consultant - Radiology
Note: (1) This report is NOT valid for medico-legal purposes.
(2) In case of any discrepancy due to machine error or typing error, please get it rectified immediately.
I was diagnosed with developing chronic pancreatitis last year based on EUS symptoms like Hyperechoic foci, strands and lobulations, cyst , and dialated pancreatic duct of 3mm in body region. There was no pain or calcification or stone or strictures. i was also bit diabetic. Now after 1 year i started having having oily stools after oily food one day. this process continued for few days and i started getting oily stools on and off after some oily or heavy food. My doctor given me pancreatitic enzymes creon. I have also lost 2 kg weight in last 2 months. MY gall bladder was also removed last year.
I have gone through MRCP today and report of MRCP is as below :-
DEPARTMENT OF RADIODIAGNOSIS AND IMAGING
Patient Name
: XXXXXXX XXXX
Procedure Date
: 12/09/2015
UHID
: JHN0000
Order From
: RADIOLOGY-BILL-GF-AB
Age/Sex
: 35Y/M
Accession No.
: SC115MR0000
Requested By
: DR. XXXXXXX XXXX
Investigation
: MRCP
Ordered Time
: 12/09/2015
Reported Time
: 12-9-2015 10:43:49
MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY
PROCEDURE
MRCP was performed on 3 Tesla scanner using heavily T2 weighted sequences in coronal and oblique coronal planes. T1 as well as T2 weighted images were also obtained through the liver and pancreas.
Clinical details- Status post Cholecystectomy on ATT for periportal lymph nodes. Previous history of acute pancreatitis.
FINDINGS
Liver is normal in size and shows normal signal intensity. No focal lesion seen. The intrahepatic biliary radicals are not dilated. No SOL. Hepatic vein and portal vein seen normal.
Gall bladder is not visualised (operated).
Pancreas is atrophic with irregular dilated pancreatic duct with dilated ductules. There is a well defined cyst measuring 2.4 x 1.9 cm in pancreatic head – communicating with pancreatic duct.
Two other cysts measuring 2.6 x 1.8 & 1.5 x 1.1 cm are seen anterosuperior to pancreatic body partially within the pancreatic parenchyma. The cysts are not communicating with the pancreatic duct.
Portal & splenic veins are normal. Flow void of splenic artery is normal.
There are multiple periportal & Peripancreatic lymph nodes, largest measuring 2.3 x 1.8 cm.
MRCP-
Intrahepatic biliary radicals are normal.
CBD is normal in course and calibre ( 6.3 mm ). No intraluminal signal void/calculus in CBD.
IMPRESSION: 1. Chronic pancreatitis with pseudocysts
2. Multiple periportal & Peripancreatic lymph nodes.
Dr. XXXXXXX Garg
MD,DNB
Sr. Consultant - Radiology
Note: (1) This report is NOT valid for medico-legal purposes.
(2) In case of any discrepancy due to machine error or typing error, please get it rectified immediately.
Brief Answer:
Please see detail below
Detailed Answer:
Hello Mr XXXXXXX XXXX. Thanks for putting your query in HCM. I am a Gastroenetrologist (DM). I have gone through your problem and reports. Since you are having oily stools and weight loss suggest that you have developed exocrine insufficiency , the treatment of choice for which is pancreatic enzymes which your doctor has prescribed you in form of creon tablets. Among diet you should take less fatty diet, fat should not be more than 20gm/day. Also take some proton pump inhibitors to prevent pancreatic enzymes to reach at appropriate part of intestine.
For the pseudocyst, presently there is nothing to be done as these are very small and may resolve spontaneously.
However for lymphnodes I will suggest you to get a repeat EUS during which FNAC (Fine needle aspiration and cytology) or may be biopsy of the lymph node will be done to see for the cause of lymph node enlargement.
I hope I have answered your query and this will help you. Wish you a good health
Please see detail below
Detailed Answer:
Hello Mr XXXXXXX XXXX. Thanks for putting your query in HCM. I am a Gastroenetrologist (DM). I have gone through your problem and reports. Since you are having oily stools and weight loss suggest that you have developed exocrine insufficiency , the treatment of choice for which is pancreatic enzymes which your doctor has prescribed you in form of creon tablets. Among diet you should take less fatty diet, fat should not be more than 20gm/day. Also take some proton pump inhibitors to prevent pancreatic enzymes to reach at appropriate part of intestine.
For the pseudocyst, presently there is nothing to be done as these are very small and may resolve spontaneously.
However for lymphnodes I will suggest you to get a repeat EUS during which FNAC (Fine needle aspiration and cytology) or may be biopsy of the lymph node will be done to see for the cause of lymph node enlargement.
I hope I have answered your query and this will help you. Wish you a good health
Above answer was peer-reviewed by :
Dr. Prasad
Sir is it actually a chronic pancreatitis. I am not able to understand why chronic pancreatitis to me I am not a drinker nor gall stones
Brief Answer:
Yes it is chronic pancreatitis
Detailed Answer:
Welcome back. There is no doubt that this is a chronic pancreatitis. There are many causes for chronic pancreatitis apart from alcohol or gallstone, like genetics, tropical and many a times idiopathic means no cause. So be cool. Go ahead with the advise. If you do not have any further query , you can close the discussion and rate the answer. Wish you a good health.
Yes it is chronic pancreatitis
Detailed Answer:
Welcome back. There is no doubt that this is a chronic pancreatitis. There are many causes for chronic pancreatitis apart from alcohol or gallstone, like genetics, tropical and many a times idiopathic means no cause. So be cool. Go ahead with the advise. If you do not have any further query , you can close the discussion and rate the answer. Wish you a good health.
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. I want more details about my reason and staging of chronic pancreatitis. Can u pls. Transfer my request to some pancreatic specialist
Brief Answer:
See below
Detailed Answer:
Hello! I dont think you require more detail regarding at least staging. You may discuss with specialist of pancreas if you think so. If you do not have any further query , you can close the discussion and rate the answer. Wish you a good health
See below
Detailed Answer:
Hello! I dont think you require more detail regarding at least staging. You may discuss with specialist of pancreas if you think so. If you do not have any further query , you can close the discussion and rate the answer. Wish you a good health
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Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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