Criteria for the diagnosis of chronic pancreatitis on endoscopic ultrasonography (EUS) were developed at a conference held at Rosemont, Illinois in 2007. The authors are from North America and Japan.
Finding on EUS
Major Criteria
hyperechoic parenchymal foci with shadowing (echogenic structures >= 2 mm in diameter that shadow)
A1
calculi in the main pancreatic duct (echogenic structure in the main pancreatic duct with acoustic shadowing)
A2
parenchymal lobularity with honeycombing (>= 3 contiguous lobules)
B
Minor criteria:
(1) parenchymal lobularity without honeycombing (noncontiguous lobules)
(2) hyperechoic foci in the parenchyma without shadowing
(3) parenchymal cysts
(4) parenchymal stranding
(5) irregular main pancreatic duct contour
(6) dilated side branches from the main pancreatic duct
(7) dilated main pancreatic duct
(8) hyperechoic main pancreatic duct margin
Major A
Major B
Number of Minor
Interpretation
1
NA
>= 3
consistent with
1
1
NA
consistent with
2
NA
NA
consistent with
1
NA
< 3
suggestive of
0
1
>= 3
suggestive of
0
0
>= 5
suggestive of
0
0
3 or 4
indeterminate for
0
1
< 3
indeterminate for
0
0
< 3
normal
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