nach oben

Abdominal Radiology

Erschienen in:

01.02.2016 | Pictorial Essay

Common and uncommon pitfalls in pancreatic imaging: it is not always cancer

verfasst von: F. Vernuccio, A. A. Borhani, M. Dioguardi Burgio, M. Midiri, A. Furlan, G. Brancatelli

Erschienen in: Abdominal Radiology | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

Despite advances in multimodality imaging of pancreas, there is still overlap between imaging findings of several pancreatic/peripancreatic disease processes. Pancreatic and peripancreatic non-neoplastic entities may mimic primary pancreatic neoplasms on ultrasound, CT, and MRI. On the other hand, primary pancreatic cancer may be overlooked on imaging because of technical and inherent factors. The purpose of this pictorial review is to describe and illustrate pancreatic imaging pitfalls and highlight the basic radiological features for proper differential diagnosis.

Matos C, Cappeliez O, Winant C, et al. (2002) MR imaging of the pancreas: a pictorial tour. Radiographics 22(1):e2. doi:10.1148/radiographics.22.1.g02jae2e2 CrossRefPubMed

McNulty NJ, Francis IR, Platt JF, et al. (2001) Multi-detector row helical CT of the pancreas: effect of contrast-enhanced multiphasic imaging on enhancement of the pancreas, peripancreatic vasculature, and pancreatic adenocarcinoma. Radiology 220(1):97–102. doi:10.1148/radiology.220.1.r01jl1897 CrossRefPubMed

Fattahi R, Balci NC, Perman WH, et al. (2009) Pancreatic diffusion-weighted imaging (DWI): comparison between mass-forming focal pancreatitis (FP), pancreatic cancer (PC), and normal pancreas. J Magn Reson Imaging 29(2):350–356. doi:10.1002/jmri.21651 CrossRefPubMed

Sandrasegaran K, Lin C, Akisik FM, Tann M (2010) State-of-the-art pancreatic MRI. AJR Am J Roentgenol 195(1):42–53. doi:10.2214/ajr.195.3_supplement.0s42 CrossRefPubMed

Dimcevski G, Erchinger FG, Havre R, Gilja OH (2013) Ultrasonography in diagnosing chronic pancreatitis: new aspects. World J Gastroenterol 19(42):7247–7257. doi:10.3748/wjg.v19.i42.7247 PubMedCentralCrossRefPubMed

Atri M, Nazarnia S, Mehio A, Reinhold C, Bret PM (1994) Hypoechogenic embryologic ventral aspect of the head and uncinate process of the pancreas: in vitro correlation of US with histopathologic findings. Radiology 190(2):441–444. doi:10.1148/radiology.190.2.8284396 CrossRefPubMed

Al-Hawary MM, Kaza RK, Azar SF, Ruma JA, Francis IR (2013) Mimics of pancreatic ductal adenocarcinoma. Cancer Imaging 13(3):342–349. doi:10.1102/1470-7330.2013.9012 PubMedCentralCrossRefPubMed

Kim JK, Altun E, Elias J Jr, et al. (2007) Focal pancreatic mass: distinction of pancreatic cancer from chronic pancreatitis using gadolinium-enhanced 3D-gradient-echo MRI. J Magn Reson Imaging 26(2):313–322. doi:10.1002/jmri.21010 CrossRefPubMed

Ichikawa T, Sou H, Araki T, et al. (2001) Duct-penetrating sign at MRCP: usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. Radiology 221(1):107–116. doi:10.1148/radiol.2211001157 CrossRefPubMed

10.

Lee SS, Byun JH, Park BJ, et al. (2008) Quantitative analysis of diffusion-weighted magnetic resonance imaging of the pancreas: usefulness in characterizing solid pancreatic masses. J Magn Reson Imaging 28(4):928–936. doi:10.1002/jmri.21508 CrossRefPubMed

11.

Gerritsen A, Molenaar IQ, Bollen TL, et al. (2014) Preoperative characteristics of patients with presumed pancreatic cancer but ultimately benign disease: a multicenter series of 344 pancreatoduodenectomies. Ann Surg Oncol 21(12):3999–4006. doi:10.1245/s10434-014-3810-7 CrossRefPubMed

12.

To’o KJ, Raman SS, Yu NC, et al. (2005) Pancreatic and peripancreatic diseases mimicking primary pancreatic neoplasia. Radiographics 25(4):949–965. doi:10.1148/rg.254045167 CrossRefPubMed

13.

Raimondi S, Lowenfels AB, Morselli-Labate AM, Maisonneuve P, Pezzilli R (2010) Pancreatic cancer in chronic pancreatitis; aetiology, incidence, and early detection. Best Pract Res Clin Gastroenterol 24(3):349–358. doi:10.1016/j.bpg.2010.02.007 CrossRefPubMed

14.

Matsubayashi H, Kakushima N, Takizawa K, et al. (2014) Diagnosis of autoimmune pancreatitis. World J Gastroenterol 20(44):16559–16569. doi:10.3748/wjg.v20.i44.16559 PubMedCentralCrossRefPubMed

15.

Manfredi R, Graziani R, Cicero C, et al. (2008) Autoimmune pancreatitis: CT patterns and their changes after steroid treatment. Radiology 247(2):435–443. doi:10.1148/radiol.2472070598 CrossRefPubMed

16.

Negrelli R, Manfredi R, Pedrinolla B, et al. (2015) Pancreatic duct abnormalities in focal autoimmune pancreatitis: MR/MRCP imaging findings. Eur Radiol 25(2):359–367. doi:10.1007/s00330-014-3371-y CrossRefPubMed

17.

Hur BY, Lee JM, Lee JE, et al. (2012) Magnetic resonance imaging findings of the mass-forming type of autoimmune pancreatitis: comparison with pancreatic adenocarcinoma. J Magn Reson Imaging 36(1):188–197. doi:10.1002/jmri.23609 CrossRefPubMed

18.

Borghei P, Sokhandon F, Shirkhoda A, Morgan DE (2013) Anomalies, anatomic variants, and sources of diagnostic pitfalls in pancreatic imaging. Radiology 266(1):28–36. doi:10.1148/radiol.12112469 CrossRefPubMed

19.

Griffin N, Yu D, Alexander Grant L (2013) Magnetic resonance cholangiopancreatography: pearls, pitfalls, and pathology. Semin Ultrasound CT MR 34(1):32–43. doi:10.1053/j.sult.2012.11.003 CrossRefPubMed

20.

Katz DS, Hines J, Math KR, et al. (1999) Using CT to reveal fat-containing abnormalities of the pancreas. AJR Am J Roentgenol 172(2):393–396. doi:10.2214/ajr.172.2.9930790 CrossRefPubMed

21.

Pokharel SS, Macura KJ, Kamel IR, Zaheer A (2013) Current MR imaging lipid detection techniques for diagnosis of lesions in the abdomen and pelvis. Radiographics 33(3):681–702. doi:10.1148/rg.333125068 CrossRefPubMed

22.

Isserow JA, Siegelman ES, Mammone J (1999) Focal fatty infiltration of the pancreas: MR characterization with chemical shift imaging. AJR Am J Roentgenol 173(5):1263–1265. doi:10.2214/ajr.173.5.10541101 CrossRefPubMed

23.

Klein KA, Stephens DH, Welch TJ (1998) CT characteristics of metastatic disease of the pancreas. Radiographics 18(2):369–378. doi:10.1148/radiographics.18.2.9536484 CrossRefPubMed

24.

Ng CS, Loyer EM, Iyer RB, et al. (1999) Metastases to the pancreas from renal cell carcinoma: findings on three-phase contrast-enhanced helical CT. AJR Am J Roentgenol 172(6):1555–1559. doi:10.2214/ajr.172.6.10350288 CrossRefPubMed

25.

Kim SH, Lee JM, Han JK, et al. (2008) Intrapancreatic accessory spleen: findings on MR Imaging, CT, US and scintigraphy, and the pathologic analysis. Korean J Radiol 9(2):162–174. doi:10.3348/kjr.2008.9.2.162 PubMedCentralCrossRefPubMed

26.

Unver Dogan N, Uysal II, Demirci S, Dogan KH, Kolcu G (2011) Accessory spleens at autopsy. Clin Anat 24(6):757–762. doi:10.1002/ca.21146 CrossRefPubMed

27.

Kawamoto S, Johnson PT, Hall H, et al. (2012) Intrapancreatic accessory spleen: CT appearance and differential diagnosis. Abdom Imaging 37(5):812–827. doi:10.1007/s00261-011-9830-x CrossRefPubMed

28.

Coquia SF, Kawamoto S, Zaheer A, et al. (2014) Intrapancreatic accessory spleen: possibilities of computed tomography in differentiation from nonfunctioning pancreatic neuroendocrine tumor. J Comput Assist Tomogr 38(6):874–878. doi:10.1097/RCT.0000000000000127 PubMedCentralCrossRefPubMed

29.

Jang KM, Kim SH, Song KD, et al. (2015) Differentiation of solid-type serous cystic neoplasm from neuroendocrine tumour in the pancreas: value of abdominal MRI with diffusion-weighted imaging in comparison with MDCT. Clin Radiol 70(2):153–160. doi:10.1016/j.crad.2014.10.010 CrossRefPubMed

30.

Kalb B, Sarmiento JM, Kooby DA, Adsay NV, Martin DR (2009) MR imaging of cystic lesions of the pancreas. Radiographics 29(6):1749–1765. doi:10.1148/rg.296095506 CrossRefPubMed

31.

Palmucci S, Mauro LA, Milone P, et al. (2010) Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass. World J Gastroenterol 16(18):2298–2301PubMedCentralCrossRefPubMed

32.

Messina LM, Shanley CJ (1997) Visceral artery aneurysms. Surg Clin N Am 77(2):425–442CrossRefPubMed

33.

Vilgrain V, Condat B, O’Toole D, et al. (2009) Pancreatic portal cavernoma in patients with cavernous transformation of the portal vein: MR findings. Eur Radiol 19(11):2608–2613. doi:10.1007/s00330-009-1459-6 CrossRefPubMed

34.

Macaluso FS, Maida M, Dioguardi Burgio M, Brancatelli G (2013) Education and imaging: hepatobiliary and pancreatic—portal hypertensive biliopathy presenting as acute cholangitis. J Gastroenterol Hepatol 28(8):1257. doi:10.1111/jgh.12295 CrossRefPubMed

35.

Lawler LP, Horton KM, Fishman EK (2003) Peripancreatic masses that simulate pancreatic disease: spectrum of disease and role of CT. Radiographics 23(5):1117–1131. doi:10.1148/rg.235035013 CrossRefPubMed

36.

Hariri A, Siegelman SS, Hruban RH (2005) Duodenal diverticulum mimicking a cystic pancreatic neoplasm. Br J Radiol 78(930):562–564. doi:10.1259/bjr/52543195 CrossRefPubMed

37.

Moriya T, Kimura W, Hirai I, et al. (2012) Pancreatic schwannoma: case report and an updated 30-year review of the literature yielding 47 cases. World J Gastroenterol 18(13):1538–1544. doi:10.3748/wjg.v18.i13.1538 PubMedCentralCrossRefPubMed

38.

Ahn SS, Kim MJ, Choi JY, et al. (2009) Indicative findings of pancreatic cancer in prediagnostic CT. Eur Radiol 19(10):2448–2455. doi:10.1007/s00330-009-1422-6 CrossRefPubMed

39.

Prokesch RW, Chow LC, Beaulieu CF, Bammer R, Jeffrey RB Jr (2002) Isoattenuating pancreatic adenocarcinoma at multi-detector row CT: secondary signs. Radiology 224(3):764–768. doi:10.1148/radiol.2243011284 CrossRefPubMed

40.

Gangi S, Fletcher JG, Nathan MA, et al. (2004) Time interval between abnormalities seen on CT and the clinical diagnosis of pancreatic cancer: retrospective review of CT scans obtained before diagnosis. AJR Am J Roentgenol 182(4):897–903. doi:10.2214/ajr.182.4.1820897 CrossRefPubMed

41.

Ichikawa T, Haradome H, Hachiya J, et al. (1997) Pancreatic ductal adenocarcinoma: preoperative assessment with helical CT versus dynamic MR imaging. Radiology 202(3):655–662. doi:10.1148/radiology.202.3.9051012 CrossRefPubMed

42.

Bronstein YL, Loyer EM, Kaur H, et al. (2004) Detection of small pancreatic tumors with multiphasic helical CT. AJR Am J Roentgenol 182(3):619–623. doi:10.2214/ajr.182.3.1820619 CrossRefPubMed

Titel: Common and uncommon pitfalls in pancreatic imaging: it is not always cancer
verfasst von: F. Vernuccio
A. A. Borhani
M. Dioguardi Burgio
M. Midiri
A. Furlan
G. Brancatelli
Publikationsdatum: 01.02.2016
Verlag: Springer US
Erschienen in: Abdominal Radiology / Ausgabe 2/2016
Print ISSN: 2366-004X
Elektronische ISSN: 2366-0058
DOI: https://doi.org/10.1007/s00261-015-0557-y

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Common and uncommon pitfalls in pancreatic imaging: it is not always cancer

Abstract

Neu im Fachgebiet Radiologie

Akuter Schwindel: Wann lohnt sich eine MRT?

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Radiologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2016

Direct and indirect imaging features of adrenohepatic fusion

Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis

Comparison of tumor vascularity and hemodynamics in three rat hepatoma models

Impact of hysterectomy on three-dimensional rectosigmoid morphology and endoscopy performance: a pilot study

The “double bubble” sign

Impact of histologic subtype and sarcomatoid transformation on metastasis in renal cell carcinoma: a single institute experience in 149 patients

Neu im Fachgebiet Radiologie

Akuter Schwindel: Wann lohnt sich eine MRT?

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

S3-Leitlinie zu Pankreaskrebs aktualisiert

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Update Radiologie