High-b Value Diffusion-Weighted MRI for Detecting Pancreatic Adenocarcinoma: Preliminary Results
Tomoaki Ichikawa1,
Sukru Mehmet Erturk2,
Utarou Motosugi1,
Hironobu Sou1,
Hiroshi Iino3,
Tsutomu Araki1 and
Hideki Fujii3
1 Department of Radiology, University of Yamanashi, Shimokato, Japan.
2 Department of Radiology, Sisli Etfal Hospital, No. 10/1 Dogancilar, Uskudar
Istanbul 81160, Turkey.
3 Department of First Surgery, University of Yamanashi. Shimokato, Japan.
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Fig. 2A —Adenocarcinoma in head of pancreas with extensive necrosis in
58-year-old woman. Respiratory-triggered transverse T2-weighted fast spin-echo
MR image shows heterogeneously hyperintense mass (arrow) at head of
pancreas. Signal intensity of mass is high, similar to that of kidneys, which
might suggest cystic nature of mass.
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Fig. 2B —Adenocarcinoma in head of pancreas with extensive necrosis in
58-year-old woman. Breath-hold contrast-enhanced transverse T1-weighted
gradient-echo MR image obtained during pancreatic parenchymal phase clearly
shows extensive cystic area in mass (arrow).
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Fig. 2C —Adenocarcinoma in head of pancreas with extensive necrosis in
58-year-old woman. Non-breath-hold transverse diffusion-weighted MR image with
inverted black-and-white image contrast clearly depicts mass (arrow)
showing strong signal intensity despite its cystic nature.
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Fig. 2D —Adenocarcinoma in head of pancreas with extensive necrosis in
58-year-old woman. Fusion image—combination of T1- and
diffusion-weighted MR images—can facilitate identification of mass
(arrow) presenting at head of pancreas.
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Fig. 3A —Pseudocyst related to chronic pancreatitis in 60-year-old man.
Respiratory-triggered transverse T2-weighted fast spin-echo MR image reveals
well-defined mass (arrow) in tail of pancreas is showing extremely
high signal intensity, which may indicate cystic nature of mass.
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Fig. 3B —Pseudocyst related to chronic pancreatitis in 60-year-old man.
Respiratory-triggered transverse diffusion-weighted MR image with inverted
black-and-white image contrast shows no significant signals in area
corresponding to area where mass is shown in A.
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Fig. 4A —Intraductal papillary mucinous tumor, side branch type, in
71-year-old woman. Coronal MR cholangiopancreatography image shows dilated
main pancreatic duct (asterisks) and cystic mass (arrows) in
head of pancreas.
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Fig. 4B —Intraductal papillary mucinous tumor, side branch type, in
71-year-old woman. Axial T2-weighted MR image depicts same cystic mass
(arrowhead) as that shown in A. Spleen is marked with arrow to
serve as landmark for correlation with diffusion-weighted MR image.
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Fig. 4C —Intraductal papillary mucinous tumor, side branch type, in
71-year-old woman. Respiratory-triggered transverse diffusion-weighted MR
image with inverted black-and-white image contrast shows no significant
signals at area corresponding to area where mass is shown in A and
B. Spleen is marked with arrow.
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Fig. 5B —Pancreatic adenocarcinoma in body of pancreas in 56-year-old man.
Using diffusion-weighted MR image corresponding to A, all three
reviewers missed lesion (arrows) by grading it as "3"
(undetermined; localized, mild to moderate signal).
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Copyright © 2007 by the American Roentgen Ray Society.
