Reason: 71 yo M hx of recurrent acute pancreatitis, OSH imaging shows calcifications in the pancreatic tail, and pseudocyst near the head of the pancreas. MRI/MRCP to assess pancreatic parenchyma, rule out small tumor, also eval pancreatic duct and emptying History: recurrent acute pancreatitis ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: 9 mm cystic lesion within the pancreatic body with additional cystic lesions, most prominent in the pancreatic head and tail. These most likely represent dilated side branches from chronic pancreatitis. The main pancreatic duct within the head, neck and body is nondilated.There is abrupt dilatation of the main pancreatic duct involving the distal 5 cm of the tail suggesting a focal stricture or obstructing lesion. Within the associated pancreatic tail, there is atrophy with low T1 signal and diffusion restriction, which may be associated with chronic obstruction and pancreatitis.There is overall loss of lobulations throughout the pancreas with a bulbous appearing uncinate.An appropriate response is present following secretin administration.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Bilateral renal cysts.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Right chest wall lipoma measuring 0.3 cm (8/4).OTHER: No significant abnormality noted.
1.Focal stricturing of the main pancreatic duct within the pancreatic tail with associated ductal dilatation and findings suggestive of chronic pancreatitis. An obstructing lesion or stone is not visualized, however a lesion cannot be excluded at the site of obstruction. Recommend three-month follow-up MRCP if an endoscopic ultrasound is not planned.2.Loss of pancreatic lobulations and a bulbous appearing uncinate may be related to resolving pancreatitis or an autoimmune pancreatitis.