Role of MRT in pancreatic diseases in the pediatric population

Abstract

any childhood pancreatic disorders are rare, although they can represent significant and potentially severe disease. The spectrum of disease is very broad, ranging from the complex and bizarre congenital anomalies to the more typical acquired causes (e.g., drug-induced pancreatitis or trauma injury). Genetics appears to play a major role in many childhood pancreas diseases, unlike adults where alcohol is a major factor. Nevertheless, there are similarities, and most of the disorders discussed here can be found in both the pediatric and adult age groups. Some of these disorders may be evolving and may be seen in both young and older patients (Jolley, 2010). Diagnostic imaging plays a major role in the evaluation of the pancreas in infants and children. Familiarity with the range of normal appearance and the diseases that commonly affect this gland is important for the accurate and timely diagnosis of pancreatic disorders in the pediatric population (Nijs et al., 2004). CT has historically been the mainstay for noninvasive imaging of the pancreas. This modality is limited in the pediatric population because of poorly developed retroperitoneal fat planes, difficulty in evaluating the ductal anatomy, and the use of ionizing radiation. MRI with MRCP provides superior soft-tissue resolution and improved visualization of ductal anatomy and can delineate complications, while avoiding exposure to potentially harmful radiation (Thai et al., 2013). The use of MR imaging (MRI) for the evaluation of the paediatric abdomen is rapidly increasing, thanks to an easier access and to faster sequences. This evolution is welcomed since it helps to reduce the use of other examinations such as body CT with their exposition hazards. The panel of indications is widening. Like in adults, classical indications include the work-up of abdominal tumours, the evaluation of hepato-bilio-pancreatic diseases and uro-MR. Still, as the technical part is important, it may be difficult to obtain examinations with the same quality as in adults. Also, there may be a need to sedate young paediatric patients (Riccabona and Avni, 2010).