Associations between MRI and endoscopic ultrasound findings in the pancreas in children and young adults with suspected chronic pancreatitis

Introduction

Endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI) are both used to diagnose pancreatitis but how findings relate across modalities has not been defined in children. Our aim is to characterize associations between pancreas imaging findings on EUS and MRI in children.

Methods

We retrospectively reviewed pediatric patients (age <21-years) who underwent EUS January 2019 to December 2023 and had an MRI of the abdomen within 90 days of EUS. MRIs were independently reviewed by three radiologists and EUS reports were reviewed to extract Rosemont Criteria findings. The association between MRI findings, Rosemont Criteria classification, and individual EUS findings was calculated using Pearson correlation coefficients, Pearson contingency test and F-test.

Results

Ninety-nine patients, 18 with ARP, 16 with CP as indications for EUS were included. Mean age was 13.5 ± 4.1 years. Rosemont Criteria classifications were: normal = 64 (64.7 %), indeterminate = 19 (19.2 %), suggestive = 3 (3.0 %), and consistent = 13 (13.1 %). Imaging was consistent with CP in 4/18 (EUS) and 4/18 (MRI) patients with an indication of ARP and 9/16 (EUS) and 7/16 (MRI) patients with an indication of CP. Rosemont Criteria classification was moderately associated with MRI pancreatic duct abnormalities (coefficients = 0.57 to 0.60) and subjective pancreatic atrophy (coefficient = 0.57). Associations between individual EUS and MRI features were very weak to moderate and were highest for main duct findings (coefficient ≤ 0.63).

Conclusion

MRI findings related to the pancreatic duct and of parenchymal atrophy were moderately associated with EUS Rosemont Criteria classification. Correlations between individual EUS and MRI findings generally ranged from weak to moderate and were highest (coefficient ≤ 0.63) for main duct findings.