Learning objectives
The present paper aims:
to list and illustrate the most important imaging features of malignant pancreatic cystic lesions (PCL),
and
to discuss the differential diagnosis of these lesions.
Background
PCL may be benign,
with malignant potential or overt malignant masses.
Imaging aspects are of rising importance because they represent a non-invasive,
relatively accurate method of establishing a diagnosis.
General considerations regarding PCL:
Increasingly discovered on cross-sectional imaging [1,2]
Accurate assessment is important for management [1-4]
Pancreatic cystic neoplasms represent a histological heterogeneous collection of neoplasms,
showing a spectrum of diagnoses,
from completely benign to potentially malignant,
carcinoma in situ,
frankly invasive and malignant [2,3]
Studies using MRI imaging established an overall prevalence ofPCL of...
Findings and procedure details
We revised cases of PCL explored in our department in the last 5 years with tomography (CT) and/or magnetic resonance imaging (MRI).
We correlated the imaging findings with the histopathological report.
Our focus was mainly on potentially malignant and malignant lesions.
Imaging techniques
CT:
- multi-slice,
depicts most pancreatic lesions
- native and post-i.v.
contrast multi-phase acquisition
-best method to assess vascular involvement
MRI with cholangiopancreatography (MRCP):
- detection and staging of pancreatic lesions,
more diagnostic than CT
- evaluation of the pancreatic duct and...
Conclusion
Imaging aspects in PCL are essential for framing them correctly - identifying those with malignant potential for choosing the optimal treatment.
Patient's age,
gender,
history,
clinical and biological context are important for the orientation of the diagnosis and management of the case.
Ultrasound is the first intention method with high rate of incidental finding,
but CT remains the best method of detection and staging in patients with pancreatic lesions,
with assessment of the vascular involvement as well.
MRI should always be performed because it is...
References
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