Tuberculosis of the Pancreas: MRI Features
A. I. De Backer1,
K. J. Mortelé2,
P. Bomans3,
B. L. De Keulenaer4,
I. J. Vanschoubroeck3 and
M. M. Kockx5
1 Department of Radiology, Stuivenberg, Ziekenhuisnetwerk Antwerpen, Lange
Beeldekensstraat 267, Antwerp B-2060, Belgium.
2 Department of Radiology, Division of Abdominal Imaging and Intervention,
Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston,
MA 02115.
3 Department of Internal Medicine, Stuivenberg, Ziekenhuisnetwerk Antwerpen,
Antwerp B-2060, Belgium.
4 Intensive Care Unit, Royal Darwin Hospital, Rocklands 0810, TIWI, Northern
Territory, Australia.
5 Department of Pathology, Stuivenberg, Ziekenhuisnetwerk Antwerpen, Antwerp
B-2060, Belgium.
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Fig. 1A. —30-year-old man with tuberculous involvement of head of
pancreas and spleen and tuberculous spondylitis. T2-weighted single-shot fast
spin-echo image shows heterogeneous mass with increased and decreased signal
intensities. No dilatation of main pancreatic duct is seen.
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Fig. 1B. —30-year-old man with tuberculous involvement of head of
pancreas and spleen and tuberculous spondylitis. Gadolinium-enhanced
T1-weighted gradient-recalled-echo image obtained with fat suppression shows
sharply delineated heterogeneous mass with multiloculated appearance.
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Fig. 2A. —23-year-old woman with tuberculous involvement of head of
pancreas and "wet" peritoneal tuberculosis. T2-weighted
single-shot fast spin-echo image shows heterogeneous mass in head of pancreas
with central and peripheral hyperintensities. Obstruction and dilatation of
main pancreatic duct is not present.
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Fig. 2B. —23-year-old woman with tuberculous involvement of head of
pancreas and "wet" peritoneal tuberculosis. On unenhanced
T1-weighted gradient-recalled-echo image obtained with fat suppression, lesion
is hypointense compared with normal pancreatic tissue.
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Fig. 2C. —23-year-old woman with tuberculous involvement of head of
pancreas and "wet" peritoneal tuberculosis. Gadolinium-enhanced
T1-weighted gradient-recalled-echo image obtained with fat suppression shows
sharply delineated mass with peripheral and central areas of enhancement.
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Fig. 3A. —47-year-old woman with diffuse enlargement of pancreas and
abdominal lymphadenopathy caused by Mycobacterium tuberculosis.
T2-weighted single-shot fast spin-echo image shows diffusely enlarged,
hyperintense pancreas.
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Fig. 3B. —47-year-old woman with diffuse enlargement of pancreas and
abdominal lymphadenopathy caused by Mycobacterium tuberculosis. On MR
cholangiopancreatography image, diffuse narrowing of main pancreatic duct is
noted.
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Fig. 3C. —47-year-old woman with diffuse enlargement of pancreas and
abdominal lymphadenopathy caused by Mycobacterium tuberculosis.
T1-weighted gradient-recalled-echo image obtained with fat suppression shows
heterogeneously decreased signal intensity of pancreas.
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Fig. 3D. —47-year-old woman with diffuse enlargement of pancreas and
abdominal lymphadenopathy caused by Mycobacterium tuberculosis.
Slightly heterogeneous enhancement is seen on gadolinium-enhanced T1-weighted
gradient-recalled-echo image obtained with fat suppression.
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Copyright © 2005 by the American Roentgen Ray Society.
