Pancreatic imaging in Shwachman-Diamond syndrome

(A) Normal pancreas in a seven-year-old girl. A transverse sonogram of the upper abdomen shows the normal pancreas (arrows), which is isoechoic to liver.
(B) Pancreas in a three-year-old boy with Shwachman-Diamond syndrome. Transverse sonogram of the upper abdomen reveals an enlarged, diffusely echogenic pancreas (arrows) due to fatty infiltration. Note normal adjacent liver (L).
(C) Normal pancreas in a 16-year-old girl. A transverse computed tomography image demonstrates a normal pancreas. The density of the pancreas (arrows) is similar to liver.
(D) Pancreas in a five-year-old boy with Shwachman-Diamond syndrome. Transverse contrast-enhanced computed tomography image shows diffuse fatty infiltration of the pancreas (arrowheads). Similar computed tomography findings can be seen with cystic fibrosis.