[The pathological endoscopic pancreatogram diagnostic value of radiomorphological changes (author's transl)]

The specificity of abnormal radiomorphological patterns in the endoscopic retrograde pancreatogram (ERCP) has been studied. Out of 3,000 ERCPs 381 contained pathological findings in the pancreatic duct, all of which was subsequently checked by histology. Comparison of the radiomorphologic data and the histologic abnormalities has revealed that ductal abnormalities are not specific to the underlying pancreatic disease. There are, however, changes in the radiomorphologic appearance which, owing to their greater incidence, may be regarded as characteristic to some pathologic process. Solitary stenosis or complete obstruction indicate the presence of tumour, nonsegmental extended dilatation points to papillary stenosis, filling of cavities reveals cysts, while diffuse abnormalities occur most frequently in chronic pancreatitis. Opacification of the bile ducts may yield complementary data, although their specificity is not absolute either. Nonsegmental stenosis of the intrapancreatic bile duct indicate chronic inflammation, while irregular narrowing supports the diagnosis of pancreatic tumours. Arc-shaped dislocation of the bile duct is frequently observed in response to cysts, stenosis confined to the ampullary segment and associated with dilated biliary system are characteristic findings in papillary stenosis. Thus the diagnostic value of the abnormal pancreatogram may be enhanced by simultaneous study of the biliary morphology