Diagnostic imaging, including magnetic resonance (MR) imaging, plays an important role in diagnosing pancreatic disease in the pediatric population. MR cholangiopancreatography (MRCP) is a valuable noninvasive method for evaluating the pancreas and pancreaticobiliary tree. While MR imaging remains challenging in children, in recent years, novel pulse sequences have greatly improved image quality by increasing the speed of image acquisition and decreasing/compensating for motion and respiratory artifacts.
This chapter reviews the up-to-date and fundamental basics of pediatric pancreatic MR imaging protocols. Familiarity with the normal development and appearance of the pancreas allows radiologists to provide accurate and timely diagnoses. Therefore, this chapter discusses pancreatic embryology and common and less common congenital anomalies, including pancreas divisum, annular pancreas, agenesis and hypoplasia of the pancreas, and pancreatic ectopia. Next, congenital disorders which affect the pancreas are reviewed, including von Hippel-Lindau disease syndrome, cystic fibrosis, and Shwachman-Diamond syndrome. In these disorders, the pancreas undergoes cystic or fatty degeneration.
Pancreatitis is the most common pancreatic disease in children and may cause significant morbidity and mortality. MR imaging may play an important role in diagnosis and prognosis, as nearly a quarter of children eventually develop severe complications. The imaging features of acute pancreatitis, its complications, and chronic pancreatitis are described in this chapter.
Pancreatic neoplasms are fortunately uncommon in children. Even the most common pancreatic tumor, pancreaticoblastoma, is quite rare. The typical imaging and demographic features of pancreaticoblastoma and other pediatric pancreatic tumors are discussed, including solid pseudopapillary tumor, islet cell tumors, and lymphoma.
Lastly, this chapter also briefly discusses pancreatic traumatic injury, which may occur with seatbelt-type injuries or non-accidental trauma.
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