Advanced pediatric imaging can improve diagnosis, target treatment, reduce the need for invasive procedures and enable better outcomes for your child. At Children’s Hospital of Philadelphia (CHOP), a core team of experienced radiologists use a variety of imaging techniques to give clinicians the information they need to accurately diagnose your child and develop a customized care plan. 

Imaging children is a special skill. At CHOP, everyone involved in imaging for your child is highly trained – from the technologists who get the images to the pediatric radiologists who interpret them. Our team performs a wide range of imaging studies to help clinicians figure out what is going on with your child’s pancreas. We perform these studies on the smallest newborns to young adults – all with the same skill and precision. 

Our radiology team meets regularly with gastroenterologists, pancreatologists, endoscopists and surgeons to discuss each child’s imaging needs. Our goal is to make sure your child’s entire team is fully informed when deciding on a course of treatment for your child’s specific pancreatic disorder.  

The benefits of dedicated pediatric radiologists   

Physicians at CHOP make life-changing decisions every day, backed up by radiologists who have additional training in interpreting pediatric images. Within our group of pediatric radiologists, we have a dedicated team who focuses specifically on the pancreas.    

In addition to offering the newest imaging technologies, our team of pancreatic radiologists participate in national and international collaborations to establish standards of care for pancreatic imaging.    

The physicians and surgeons in the Pancreatic Disorders Program meet with CHOP radiologists regularly to discuss images that were performed at CHOP and elsewhere to develop the best plan to treat your child. Sometimes, we may recommend that imaging be repeated at CHOP even if your child has had the same studies performed elsewhere. Usually, this is because we may use slightly different – or more updated – techniques to get crucial information that may be helpful in planning your child’s treatment.

The following innovative imaging approaches are available to children being treated in the Pancreatic Disorders Program at CHOP.   

Ultrasound

A pediatric ultrasound uses sound waves to produce images of the organs and soft tissues inside the body that can be viewed live on a computer screen. It is non-invasive and does not require your child to be sedated.

Ultrasound produces some of the highest-resolution imaging we can get of the pancreas, the pancreatic ducts and the bile ducts.

By using ultrasound, we can look for:   

• Pancreatic inflammation and scarring in patients with pancreatitis
• Gallstones or pancreatic stones in patients with pancreatitis
• Fluid collections as a result of pancreatitis, like a pseudocyst or walled-off necrosis
• Some types of pancreatic tumors

Learn more about ultrasound at CHOP.

Endoscopic ultrasound (EUS)

Endoscopic ultrasound (EUS) uses endoscopy and ultrasound to produce detailed images of your child’s digestive tract and the surrounding tissue and organs. Learn more about EUS.

Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that allows physicians to diagnose, evaluate and treat problems in your child’s liver, gallbladder and pancreas, as well as the pipes (ducts) that drain these organs. The procedure combines X-ray and the use of an endoscope, a long, flexible tube with a light and tiny camera at the end. Learn more about ERCP.

Contrast-enhanced ultrasound (CEUS)

Sometimes, our radiologists may recommend that we inject contrast through an IV during your child’s ultrasound to get more detailed information. We may use contrast-enhanced ultrasound (CEUS) to:

• Characterize pancreatic tumors
• Diagnose necrotizing pancreatitis  

CHOP’s radiologists are international experts in using ultrasound and CEUS to detect disorders that would be missed with a regular ultrasound. Learn more about CEUS.

Computed tomography (CT) scan

Computed tomography (CT), sometimes called a CAT scan, uses X-rays and computers to create a high-resolution image of the inside of your child’s body. The CT machine makes images that are different from a regular X-ray and uses lower doses of radiation. The CT makes cross-sectional images of the body, most often referred to as “slices.” Just imagine looking at a piece of bread from the middle of the loaf. That’s what a CT machine can do. The CT scanner takes pictures of different sections – or slices – of the pancreas and the surrounding abdomen as the body moves through the machine.  

CT scans usually require your child to have an IV line placed to deliver medication before the scan.  The scans can be performed quickly and can help clinicians diagnose acute pancreatitis, necrotizing pancreatitis and complications of these disorders, especially if your child is too sick for an ultrasound. Learn more about CT scans at CHOP.

Magnetic resonance cholangiopancreatography (MRCP)

An MRI (Magnetic Resonance Imaging) is a diagnostic imaging procedure that uses powerful magnets, radio waves and a computer to produce images of your child’s organs and body structures. MRCP (magnetic resonance cholangiopancreatography) is a special type of MRI that focuses on the pancreas, pancreatic ducts, gallbladder and bile ducts. Most MRCPs do not require contrast or even an IV, unless the child is very young and needs to be sedated to improve the quality of the study.

Conditions that can be diagnosed or assessed with an MRCP include:

• Autoimmune pancreatitis
• Chronic pancreatitis
• Subtle or rare abnormalities of the pancreatic or bile ducts that can cause pancreatitis
• Pancreatic fluid collections like pseudocysts or walled-off necrosispseudocysts or walled-off necrosis
• Tumors that may be causing obstruction of pancreatic and/or bile ducts

Learn more about MRI at CHOP or watch Getting an MRI: A Cartoon for Kids. (see below)

MRCP with secretin

Sometimes, we recommend the MRCP be performed on your child with an IV injection of a hormone called secretin. Secretin is the hormone the body makes when food starts to leave the stomach and pass into the intestines, stimulating the pancreas to release its enzymes and juices to digest the food. When we give secretin during an MRCP, we can watch how well your child’s pancreas secretes its juices, giving us a more detailed picture of the structure of your child’s pancreatic ducts, as well as an estimate of how well their pancreas is working.

CHOP radiologists are international experts in using MRCP with secretin to detect subtle pancreatic abnormalities or disorders that would be missed with a regular MRCP.

Why choose CHOP for pediatric pancreatic imaging?

Radiologists who work with the Pancreatic Disorders Program at Children’s Hospital of Philadelphia (CHOP) are global pioneers in using ultrasound and MRCP to improve the diagnosis of pancreatic diseases and offer the most comprehensive and state-of-the art approaches to imaging.  

Our program is one of the busiest pediatric pancreatic imaging centers in the country, offering a pancreas-focused multidisciplinary team, advanced diagnostic imaging, quick scheduling of appointments and dedicated nurse coordinators to help your family at every step.  

Our expert team includes world leaders in pancreatic diseases who are constantly seeking to improve care, find new treatment options and improve outcomes. We are actively involved in clinical research, safety and quality improvement programs.