Current State of Imaging of Pediatric Pancreatitis: AJR Expert Panel Narrative Review.

Pancreatitis is as common in children as it is in adults, though causes and accepted imaging strategies differ in children. In this narrative review we discuss the epidemiology of childhood pancreatitis and key imaging features for pediatric acute, acute recurrent, and chronic pancreatitis. We rely heavily on our collective experience in discussing advantages and disadvantages of different imaging modalities; practical tips for optimization of ultrasound, CT, and MRI with MRCP in children; and image interpretation pearls. Challenges and considerations unique to imaging of pediatric pancreatitis are discussed, including timing of imaging, role of secretin-enhanced MRCP, utility of emergent MRI, severity prediction, autoimmune pancreatitis, and best methods for serial imaging. We suggest a methodical approach to pancreatic MRI interpretation in children, including a sample structured report, and we provide consensus statements based on our experience imaging children with pancreatitis.