Schneider et al report the M-ANNHEIM system for evaluating a patient with chronic pancreatitis. This includes criteria for grading by endoscopic ultraound (EUS). The system was developed at the the University of Heidelberg in Mannheim, Germany.
Patient selection: chronic pancreatitis
Ductal features:
(1) increase in duct wall echogenicity
(2) irregularity of the main pancreatic duct
(3) dilation of the main pancreatic duct
(4) visibility of side branches (from dilatation)
(5) calcifications
Parenchymal features:
(1) change in gland size
(2) cysts
(3) echo-poor lesions (reduced echogenicity)
(4) echo-rich lesions > 3 mm in diameter
(5) accentuation of a lobular pattern (echo-poor normal parenchyma surrounded by hyperechoic strands)
total number of abnormal features =
= SUM(points for all 10 parameters)
Interpretation:
• minimum number of abnormal features: 0
• maximum number of abnormal features: 10
|
Number of Abnormal Features
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Designation
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0 (all normal)
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normal
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<= 4
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low-grade (equivocal to mild)
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|
5 to 10
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high-grade (moderate to severe)
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