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Hepatobiliary and Pancreatic Manifestations of Cystic Fibrosis: MR Imaging Appearances¹

¹ From the Departments of Radiology (L.J.K., E.D.S., J.C.H.) and Gastroenterology (N.M., S.G.J.W., D.W.), Chelsea and Westminster Hospital, London SW10 9NH, England. Presented as a scientific exhibit at the 1998 RSNA scientific assembly. Received April 15, 1999; revision requested May 11 and received July 14; accepted July 15. Address reprint requests to J.C.H.

Magnetic resonance (MR) imaging and MR cholangiopancreatography are useful, noninvasive techniques for the assessment of pancreatic and hepatobiliary complications in cystic fibrosis. Abnormalities of the pancreas in cystic fibrosis are typically characterized by fat deposition, which has increased signal intensity on T1-weighted MR images, and pancreatic fibrosis, which has low signal intensity on both T1- and T2-weighted images. Pancreatic cysts are a relatively common finding; these cysts are typically quite small but are well demonstrated at MR imaging and MR cholangiopancreatography. Pancreatic duct abnormalities are also occasionally seen. Hepatic manifestations range from hepatomegaly and diffuse fatty infiltration to severe cirrhosis with fibrotic change, regenerative nodules, and portal hypertension. Splenomegaly is often characterized by siderotic nodules that manifest as multiple focal areas of abnormal low signal intensity within the spleen. Biliary manifestations include cholelithiasis, stricturization, and narrowing or dilatation of intra- and extrahepatic bile ducts. Gallbladder abnormalities including microgallbladder are also readily demonstrated. MR cholangiopancreatography can be used to help determine the presence and severity of biliary complications without resorting to more invasive procedures and, in conjunction with MR imaging, may prove useful in the assessment of patients with cystic fibrosis who present with abdominal symptoms that suggest hepatobiliary involvement.

Index Terms: Bile ducts, diseases, 76.1496, 76.28 • Fibrosis, cystic, 76.1496, 77.1496 • Liver, diseases, 761.1496, 761.371, 761.794 • Pancreas, diseases, 770.1496 • Spleen, diseases, 775.1496, 775.372

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