Transplant pancreas imaging

  • Graft rejection is best demonstrated by MRI
  • T1 drop in signal to similar to skeletal muscle
  • T2 signal similar to fluid 
  • Perfusion studies will demonstrate decreased blood flow
  • Acute rejection: Gland will be swollen with patchy areas of decreased attenuation
  • Chronic rejection: gland is diffusely hyper echoic and reduced in size
  • Tc 99m DTPA is also useful with 86% sensitivity 
  • Transplant pancreatitis and perigraft collection is not uncommon