Schneider et al report the M-ANNHEIM system for evaluating a patient with chronic pancreatitis. Changes on imaging studies are graded according to the Cambridge criteria. The system was developed at the the University of Heidelberg in Mannheim, Germany.
Patient selection: chronic pancreatitis
Imaging modalities: CT, US, MRI, MRCP
Parameters:
(1) abnormal features
(2) pancreatic duct
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Abnormal Features
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Pancreatic Duct
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Marked Changes
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Grade
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|
none
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normal
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none
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normal
|
|
1
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normal
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none
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equivocal
|
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2 or more
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normal
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none
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mild changes
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2 or more
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minor abnormalities
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none
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moderate changes
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|
NA
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NA
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one or more
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marked changes
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Abnormal features:
(1) duct dilatation: mild dilatation of the main pancreatic duct (2 to 4 mm)
(2) gland enlargement: mild (up to 2 times normal)
(3) cavities: small (<= 10 mm)
(4) ducts: irregular
(5) heterogeneous parenchyma
(6) focal acute pancreatitis
(7) increased echogenicity of the main pancreatic duct wall
(8) irregular head and/or body contour
Marked changes:
(1) duct dilatation: severe
(2) gland enlargement: gross (more than 2 times normal)
(3) cavities: large (> 10 mm)
(4) ducts: obstruction, stricture or gross irregularity
(5) intraductal filling defects or calculi
(6) contiguous organ invasion
