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British Journal of Radiology (2003) 76, 857-865
© 2003 British Institute of Radiology
doi: 10.1259/bjr/16642775
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State-of-the-art imaging of pancreatic neoplasms

M K Kalra, MD, DNB, M M Maher, MD, FFR (RCSI), FRCR, P R Mueller, MD and S Saini, MD

Department of Abdominal Imaging and Intervention, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA



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  		Figure 1. (a) Dynamic contrast enhanced axial CT image of a 55-year-old man with known pancreatic adenocarcinoma. A hypodense, mildly enhancing mass is seen in the pancreatic head and neck involving the common bile duct and proximal portal vein. Note the filling defect in superior mesenteric vein suggests vein thrombosis (large arrow) and retrocaval lymphadenopathy (small arrow). (b) Coronal reformation of the axial source image demonstrates the vascular relation of the mass. Narrowing of the proximal portal vein is exquisitely demonstrated on this three-dimensional rendering (arrows).

 


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  		Figure 2. (a) 57-year-old man with biopsy proven pancreatic neuroendocrine tumour (insulinoma). Axial T1 weighted image shows a well-defined hypointense mass in the pancreatic head. (b) T2 weighted image shows a typical high signal intensity mass (arrow) relative to the normal pancreatic parenchyma.

 


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  		Figure 3. (a) Axial post-contrast CT image of a 70-year-old woman with mucinous cystadenocarcinoma. A large well-defined cystic mass with focal calcification (arrow) and thick irregular wall is seen in the distal pancreatic body. (b) Axial CT image acquired at a slightly caudal position reveals a large eccentric mural nodule (arrow) typical of a malignant cystic neoplasm.

 


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  		Figure 4. (a) Coronal heavily T2 weighted image of 62-year-old woman showing a lobulated cystic mass (arrow) in the uncinate process of pancreas suggestive of branch duct type intraductal papillary mucinous tumour. (b) Three-dimensional thick slab, heavily T2 weighted magnetic resonance cholangiopancreatography image shows a "grape-like" lobulated cystic mass (large arrow) in relation with the uncinate portion of main pancreatic duct (small arrow). The common bile duct appears normal (curved arrow).

 


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  		Figure 5. Axial post-contrast CT image of a 76-year-old man with biopsy proven pancreatic lymphoma. A large non-enhancing, hypodense mass is seen in the pancreatic head engulfing the common bile duct (arrowhead) and superior mesenteric vessels (small arrows). Focal lymphomatous deposits are seen as subtle hypodense lesions in the right kidney (large arrows).

 




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