Imaging of chronic pancreatitis. Chronic pancreatitis is a combination of imaging pattern: duct abnormalities, with irregularity, enlargement alternating with stenosis, of main pancreatic duct (beading) and enlargement of branch duct (more than 3 thin branch ducts visible); intra ductal or parenchymal calcifications; parenchymal atrophy, global or focal. When CT is typical, no more imaging is needed. On the contrary, MRI with MRCP (2 D one) is necessary to explore doubtful chronic pancreatitis, particularly to find out discrete ductal irregularities. Then pancreas ductal carcinoma could be depicted, particularly with long lasting chronic pancreatitis, and new onset or relapse of pain. The main differential diagnosis with imaging is intra ductal pancreatic mucinous neoplasia (IPMN).
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