Interpretación de las pruebas de imagen en la patología pancreática e interpretación clínica

Imaging in pancreatic diseases involve radiologic (abdominal ultrasound, computed tomography [CT], magnetic resonance imaging [MRI] and endoscopic techniques (endoscopic retrograde cholangiopancreatography [ERCP], endoscopic ultrasound [EUS]). In acute pancreatitis, an abdominal ultrasound must be the first examination and, if there is any doubt in diagnosis, a CT must be performed. The latter is also indicated to confirm the severity of the episode. However, abdominal ultrasound or MRI are recommended to follow up local complications. Regarding the etiologic diagnosis of the acute pancreatitis episode both EUS and magnetic resonance cholangio-pancreatography (MRCP) are the most useful techniques. CT is the best technic to diagnose advanced chronic pancreatitis, but early morphological changes can be detected by MRI, MRCP and EUS. Finally, in pancreatic adenocarcinoma, the best schedule is to perform a CT initially followed by an EUS which allows to get histological or cytological samples in order to confirm the diagnosis