Advances in MRI in the Evaluation of Chronic Pancreatitis and the Less Common Forms of Pancreatitis

Pancreatitis is the most common pancreatic disease in children and adults and can be acute or chronic and can result in progressive, permanent structural changes to the pancreatic parenchyma and ductal system. While acute interstitial pancreatitis is the most common type, less common forms occur and include autoimmune pancreatitis, paraduodenal (groove) pancreatitis, heterotopic pancreatitis and annular pancreatitis. Radiologists play an important role in the diagnosis of pancreatitis, its subtypes, complications and mimickers; thus, knowledge of the various imaging features is crucial. While CT is frequently utilized in evaluating pancreatitis, magnetic resonance (MR) cholangiopancreatography (MRCP) allows for improved ductal assessment and can be further improved by the administration of secretin. T1 mapping of the pancreas is a promising tool to distinguish between mild chronic pancreatitis and the disease-free pancreas and for the exocrine and endocrine evaluation of pancreatic function. The aim of this article is to review the key MR imaging features of the less common types of pancreatitis and discuss the use of secretin and T1-mapping for diagnosing chronic pancreatitis.