MR Imaging of Cystic Pancreatic Lesions

Abstract

Increased use of cross-sectional imaging results in the detection of cystic pancreatic lesions, many of which are discovered as incidental findings in asymptomatic patients.1 Cystic pancreatic lesions include pseudocysts in patients with pancreatitis, benign and malignant cystic neoplasms, cystic forms of primarily solid pancreatic neoplasms and metastases, and comparatively rare entities. Although there is overlap in their imaging appearance, some cystic pancreatic lesions may have MR imaging features that suggest specific diagnoses or the likelihood of malignancy. Current MR imaging techniques allow fast acquisition of images of the pancreas with high spatial and contrast resolution with minimal motion artifact. Magnetic resonance cholangiopancreatography (MRCP) uses heavily T2-weighted, fluid-sensitive sequences to obtain high-resolution images of the pancreatic and biliary ductal systems and their relation to cystic lesions. Dynamic contrast-enhanced images yield angiographic data and allow differentiation of enhancing components within pancreatic lesions from adjacent parenchyma. This article discusses the MR appearance of cystic pancreatic lesions.