Imaging in pancreas transplantation

Imaging of the pancreas transplant patient is valuable for sorting out complications that have similar clinical presentations. An understanding of the particular surgical anatomy is critical for optimal imaging assessment. Sonography is used for routine evaluation of the allograft and its vasculature. If sonography is limited or if complications are only partly visualized or not well assessed with this modality, computed tomography (CT) is beneficial for assessing complications outside the pancreatic graft, such as bowel obstruction or leak. If a patient cannot tolerate intravenous contrast, magnetic resonance imaging (MRI) is an excellent method to visualize vasculature and duct. Interventional imaging is of assistance for this patient population, with ultrasound-guided biopsy being most common. Other procedures, such as image-guided fluid aspiration or abscess drainage and diagnostic and therapeutic angiography procedures, can improve the clinical course, if the patient has a complication.