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Comparison of Contrast-Enhanced Sonography and MRI in Displaying Anatomic Features of Cystic Pancreatic Masses

¹ Department of Radiology, University Hospital G. B. Rossi, Piazzale L. A. Scuro 10, University of Verona, Verona 37134, Italy.
² Department of Radiology, New York University Medical Center, New York, NY.
³ Department of Pathology, University Hospital G. B. Rossi, University of Verona, Verona, Italy.
⁴ Department of Surgery, University Hospital G. B. Rossi, University of Verona, Verona, Italy.

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —74-year-old man with mucinous cystadenoma. Transabdominal sonogram reveals 3-cm cystic mass in pancreatic tail. Thin septa (arrow) are visible.

View larger version (95K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —74-year-old man with mucinous cystadenoma. Contrast-enhanced sonogram reveals vascularization of entire thick-walled mural structure with vascularized thin intralesional septa (arrow).

View larger version (112K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —74-year-old man with mucinous cystadenoma. T2-weighted turbo spin-echo MR image (TR/TE, 4,950/102) confirms presence of mass and shows thin intralesional septa (arrow).

View larger version (159K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —74-year-old man with mucinous cystadenoma. Photograph of pathologic specimen reveals thin septa (arrow) inside opened mucinous lesion.

View larger version (158K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —47-year-old woman with mucinous cystadenoma. Transabdominal sonogram reveals 5-cm cystic mass in pancreatic body. Visible inside lesion are thin septa (arrow) along anterior wall and small nodule (arrowhead) along posterior wall.

View larger version (133K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —47-year-old woman with mucinous cystadenoma. Contrast-enhanced sonogram reveals vascularization of entire thick-walled mural structure with vascularized thin intralesional septa (arrow). Nodule is not evident.

View larger version (192K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —47-year-old woman with mucinous cystadenoma. Photograph of pathologic specimen reveals thin septa (arrow) inside opened mucinous lesion that does not contain mural nodules.

View larger version (163K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —68-year-old man with branch duct intraductal papillary mucinous neoplasm. Transabdominal sonogram reveals 2-cm cystic lesion in pancreatic tail. Some internal structure is visible but poorly defined (arrow).

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —68-year-old man with branch duct intraductal papillary mucinous neoplasm. Contrast-enhanced sonogram reveals enhancement of nodular structure within mass (arrow).

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —68-year-old man with branch duct intraductal papillary mucinous neoplasm. T2-weighted turbo spin-echo MR image (TR/TE, 4,950/102) confirms presence of mass. Low signal intensity within mass results from nodule (arrow) as predicted with contrast-enhanced sonography.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —68-year-old man with branch duct intraductal papillary mucinous neoplasm. Photograph of operative specimen shows whitish nodule (arrow) projecting into mucinous cystic lesion. Final pathologic diagnosis was branch duct intraductal papillary mucinous neoplasm with invasive carcinoma.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —47-year-old woman with cystic endocrine tumor. Transabdominal sonogram reveals 2.5-cm cystic lesion in pancreatic body. Thin internal septum is visible (arrow).

View larger version (149K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —47-year-old woman with cystic endocrine tumor. Contrast-enhanced sonogram obtained during dynamic examination shows no enhancement of intralesional structures. Absence of intralesional septa and nodules was confirmed at gross pathologic examination. Final pathologic diagnosis was cystic endocrine tumor.

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —55-year-old woman with mucinous cystadenoma. Transabdominal sonogram reveals 3.3-cm cystic lesion (asterisk) in pancreatic body. No internal structure is visible.

View larger version (146K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —55-year-old woman with mucinous cystadenoma. Contrast-enhanced (B) and unenhanced (C) sonograms from same frame of dynamic examination. Contrast-enhanced image (B) shows very small septa (arrow), not visible in unenhanced image (C).

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —55-year-old woman with mucinous cystadenoma. Contrast-enhanced (B) and unenhanced (C) sonograms from same frame of dynamic examination. Contrast-enhanced image (B) shows very small septa (arrow), not visible in unenhanced image (C).

View larger version (183K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —55-year-old woman with mucinous cystadenoma. Photograph shows small septum (arrow) inside resected specimen. Final pathologic diagnosis was mucinous cystadenoma.

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