Pancreatitis-imaging approach

Figure 20 Autoimmune pancreatitis. A: GRE T1-weighted image; B, C: Post- contrast 3D-GRE T1-weighted images with fat-suppression during the late arterial and portal venous phases. There is evidence of diffuse pancreatic swelling with reduced T1 signal, loss of the normal pancreatic lobulation and obliteration of the pancreatic duct, associated with a rim of low T1 signal (A). The pancreas demonstrates diffuse reduced enhancement on the late arterial phase and progression of enhancement on the portal venous phase in keeping with autoimmune pancreatitis. The patient had significant biliary tree irregularities in keeping with primary sclerosing cholangitis (not shown). Additionally, there are a few bilateral wedge-shaped areas of renal hypo- enhancement in keeping with segmental infarcts.