1 - Serviço de Radiologia, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa;
- Apresentação poster no 57th European Society of Paediatric Radiology Annual Meeting
Introduction: Once considered uncommon, pancreatic diseases are increasingly recognized in the paediatric age group. In this spectrum are included inflammatory and insufficiency disorders, but also focal disease, including cystic, solid and mass-like lesions.
Objective: To provide a pictorial overview of radiological findings of common and uncommon pancreatic pathologies, including lesions presenting as pancreatic masses in children and adolescents. To discuss the imaging technique of choice and differential diagnosis in each case, as well to illustrate key imaging features that allow differentiation of these pathologies.
Material and methods: Bibliographic review and retrospective analysis based on iconographic research in our paediatric university hospital picture archiving system.
Results: Commonly a few broad categories of diseases affect the paediatric pancreas that can be characterized on imaging: acute or chronic pancreatitis, pancreatic insufficiency disorders (cystic fibrosis, Schwachman-Diamond syndrome, history of steroid therapy), cystic lesions (pseudocysts, congenital simple cysts, autosomal dominant polycystic kidney disease, von Hippel-Lindau disease, cystic fibrosis, cystic neoplasms), solid neoplastic lesions (epithelial and non-epithelial) and non-neoplastic mass-like lesions (retroperitoneal tuberculosis or hematoma). A multimodality imaging approach are often used for evaluation of pancreas. The usefulness of ultrasonography in evaluating this gland in children is well known. Computed tomography (CT) or magnetic resonance imaging (MRI) with cholangiopancreatography (MRCP) are typically required for more thorough characterization. Patient age, signs and symptoms at presentation, laboratory test results, and potential underlying cancer predisposition syndrome can be helpful when formulating a differential diagnosis.
Conclusions: Diagnostic imaging plays a major role in the evaluation of the pancreas in children. For the diagnostic radiologist, complete knowledge of typical features that commonly affect this gland plays a critical role in appropriate management of pancreatic disorders in the paediatric population.
Palavras Chave: Paediatric, Pancreas, Pathologies, Review