Pancreatic encephalopathy (MR).

Clinical Indication: patient with acute pancreatitis & seizure

Imaging Technique:

The following pulse sequences for the brain were obtained  on a high field MRI.

Axial T1 and T2 weighted images

Coronal FLAIR images

Sagittal T2 weighted images

Observations

    * Extra axial spaces: Normal in size and morphology

    * Hemorrhage: no extra axial bleeding.  

    * Ventricular system: Normal in size and morphology

    * Basal cisterns: normal

    * Cerebral parenchyma: multiple fairly defined areas of abnormal signal intensities are seen in both occipital lobes as well as the both cerebellar hemispheres. They exhibit low SI on T1 WI, high SI on T2 & FLAIR WIS. Some areas seen in cerebellar hemispheres are showing blooming in gradient WI, high signal on T1 & DWI, denoting blood. No associated significant mass effect.

    * Midline shift: none

    * Brainstem: normal

Other:

    * Calvarium: normal

    * Vascular system: normal

    * Visualized Paranasal sinuses: clear

    * Visualized Orbits: normal

    * Visualized upper cervical spine: normal

    * Sella and skull base: normal

    * Left/right mastoid air cells: normal

Impression: findings are impressive of multiple patchy areas of abnormal SI seen involving the occipital lobes as well as the cerebellar hemispheres bilaterally showing hemorrhagic foci within as described above. Considering the patient’s history of being have acute pancreatitis, the possibility of pancreatic encephalopathy should be considered. Please do correlate with other clinical findings and close follow up is advised

Reported By : DR.FAYZA ABDL HAMEED       

                          Radiologist

Report Status : Validated / Validated By :  Dr.Mohammed Mohyeldin