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Endosc Ultrasound. 2015 Jan-Mar;4(1):10-4. doi: 10.4103/2303-9027.151314.

Endoscopic ultrasound features of chronic pancreatitis: A pictorial review.

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Department of Gastroenterology Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Surgery, Copenhagen University Hospital Herlev, Denmark.


As endoscopic ultrasound (EUS) is the most sensitive imaging modality for diagnosing pancreatic disorders, it can demonstrate subtle alterations in the pancreatic parenchymal and ductal structure even before traditional imaging and functional testing demonstrate any abnormality. In spite of this fact and abundant literature, the exact role of EUS in the diagnosis of chronic pancreatitis (CP) is still not established. The EUS features to diagnose CP have evolved over a period from a pure qualitative approach to more advanced and complicated scoring systems incorporating multiple parenchymal and ductal EUS features. The rosemont criteria have attempted to define precisely each EUS criterion and thus have good inter-observer agreement. However, initial studies have failed to demonstrate any significant improvement in the inter-observer variability and further validation studies are needed to define the exact role of these criteria. The measurement of strain ratio using quantitative EUS elastography and thus allowing quantification of pancreatic fibrosis seems to be a promising new technique.


Chronic pancreatitis; endosonography; pancreatic duct

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