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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 BHALLA
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 BHALLA
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:
Steatorrhoea is known with Pancreatitis and GB Removal
Detailed Answer:
Hi
Thanks for writing in
Having gone through your reports I find there are pseudocysts which is secondary to chronic pancreatitis, but they are small enough and can be left alone for without surgery at this stage
Fatty stool commonly known as steatorrhea is common in patients post GB Removal and chronic pancreatitis
Please continue creon and take fat free diet
Keep a watch on weight, if it reduces further we might need to evaluate
Hope this helps
DO write back in case of concern
Steatorrhoea is known with Pancreatitis and GB Removal
Detailed Answer:
Hi
Thanks for writing in
Having gone through your reports I find there are pseudocysts which is secondary to chronic pancreatitis, but they are small enough and can be left alone for without surgery at this stage
Fatty stool commonly known as steatorrhea is common in patients post GB Removal and chronic pancreatitis
Please continue creon and take fat free diet
Keep a watch on weight, if it reduces further we might need to evaluate
Hope this helps
DO write back in case of concern
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Sir my question is related to findings
1. Eus hyperehoic foci strands and lobulations and also dialation in duct of 3 cm in body region
2. Ct no findings
3 Mrcp pancreatic is atrophic with irregular dialated duct and ductules.
My queries are as below
1. Are these features along with cyst say chronic pancreatitis
2. If yes then what is the staging
3. I am not alcoholic nor cholesterol or triglyceride levels are high what can be cause of my pancreatitis
4. What is the progonis of this. Can it be calcified in future and can cause lot of pain. I never had severe pain in past.
1. Eus hyperehoic foci strands and lobulations and also dialation in duct of 3 cm in body region
2. Ct no findings
3 Mrcp pancreatic is atrophic with irregular dialated duct and ductules.
My queries are as below
1. Are these features along with cyst say chronic pancreatitis
2. If yes then what is the staging
3. I am not alcoholic nor cholesterol or triglyceride levels are high what can be cause of my pancreatitis
4. What is the progonis of this. Can it be calcified in future and can cause lot of pain. I never had severe pain in past.
Brief Answer:
Yes reports suggest Chronic Pancreatitis
Detailed Answer:
Hi
Thanks for writing in again
Reply to your queries :
1] Yes the findings are consistent with chronic pancreatitis though there is some typo error in your query the pancreatic duct cannot dilate up to 3 cm it would be 3 mm
2] There are different staging but I would stage it as Stage B
3] There are many other causes which are out of scope of discussion but Tropical Chronic Pancreatitis without alcohol & smoking is seen in Indians
4] Known complications in your age of diagnosis are psuedocysts, which if increase in size might need intervention, it may go for calcification but can not be justified if it will or not but complete calcification is rare
Hope this helps
Do write back if you need any clarification
Regards
Yes reports suggest Chronic Pancreatitis
Detailed Answer:
Hi
Thanks for writing in again
Reply to your queries :
1] Yes the findings are consistent with chronic pancreatitis though there is some typo error in your query the pancreatic duct cannot dilate up to 3 cm it would be 3 mm
2] There are different staging but I would stage it as Stage B
3] There are many other causes which are out of scope of discussion but Tropical Chronic Pancreatitis without alcohol & smoking is seen in Indians
4] Known complications in your age of diagnosis are psuedocysts, which if increase in size might need intervention, it may go for calcification but can not be justified if it will or not but complete calcification is rare
Hope this helps
Do write back if you need any clarification
Regards
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Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
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