Learning objectives
To review groove pancreatitis entity and pathogenesis.
To illustrate and describe the multiple forms of presentation of groove pancreatitis and Magnetic Resonance (MR) imaging features.
Background
Paraduodenalor Groove Pancreatitis (GP) is an uncommon type of focal chronic pancreatitis affecting the groove between the head of the pancreas,
the duodenum,
and the common bile duct.
GP can be subdivided into a pure form which affects exclusively the groove,
sparing the pancreatic head (Figure 1 A),
and a segmental form,
which also extends to the pancreatic head with a clear predominance in the groove (Figure 1 B).
Findings of groove pancreatitis associated to diffuse chronic pancreatic disease should be included in GP,
because...
Findings and procedure details
MR imaging is the most accurate technique for the evaluation of GP,
and MR cholangiopancreatography (MRCP) is the primary imaging modality for the visualization of the pancreatic and biliary ducts in GP.
This entity presents a variety of MR imaging appearances which include sheet-like mass appearance,
inflammatory changes,
groove cyst lesions,
duodenal wall thickening and duodenal stenosis,
common bile duct tapering,
pancreatic duct morphology,
widening of the space between the distal pancreatic and common bile ducts and duodenal lumen on MR cholangiopancreatography and banana-shaped gallbladder....
Conclusion
Groove pancreatitis is a rare and specific form of chronic pancreatitis that affects the groove between the pancreatic head,
the common bile duct and duodenum,
thus mimicking diseases also involving these structures.
Although distinction between these different entities remains challenging,
the acknowledgement ofgroove pancreatitis MR imaging features spectrum is of outmost importance to achieve a correct diagnosis,
enabling a proper therapeutic approach for the patient.
So,
in the presence of a pancreaticoduodenal space mass with imaging features of fibrotic tissue,
associated with duodenal thickened wall...
Personal information
Marta Morna Palmeiro
Department of Radiology
Instituto Português de Oncologia de Lisboa Francisco Gentil
R.
Prof.
Lima Basto
1099-023 Lisboa
Portugal
Inês Leite
Department of Radiology
Hospital de Santa Maria
Avenida Professor Egas Moniz
1649-035 Lisboa
Portugal
Hugo Rio Tinto
Department of Radiology
Hospital de São José
Rua José António Serrano
1150-199 Lisboa
Portugal
Alessandra Farchione
Department of Radiology
Policlinico Agostino Gemelli
Largo Agostino Gemelli,
8
00168 Roma
Italy
Maria Antonietta Bali
Department of Radiology
Hôpital Erasme,
Université Libre de Bruxelles
Route de Lennik Lennikse...
References
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Triantopoulou C,
Dervenis C,
Giannakou N,
Papailiou J,
Prassopoulos P.
Groove pancreatitis: a diagnostic challenge.
Eur Radiol 2009; 19: 1736–43.
2.
Low G,
Panu A,
Millo N,
Leen E.
Multimodality Imaging of Neoplastic and Non-neoplastic Solid Lesions of the Pancreas.
RadioGraphics 2011,
31:993–1015.
3.
Shanbhogue AK,
Fasih N,
Surabhi VR,
Doherty GP,
Shanbhogue KP,
Sethi SK.
A Clinical and Radiologic Review of Uncommon Types and Causes of Pancreatitis.
RadioGraphics 2009; 29:1003–26.
4.
Castell-Monsalve FJ,
Sousa-Martin JM,
Carranza-Carranza A.
Groove pancreatitis: MRI and pathologic findings....