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Diffusion-Weighted Imaging in the Differential Diagnosis of Cystic Lesions of the Pancreas

¹ All authors: Department of Radiology, School of Medicine, University of Kocaeli, 41380 Umuttepe, Kocaeli, Turkey.

View larger version (139K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —75-year-old woman with simple cyst of pancreas. Cyst was unchanged during 12-month follow-up. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in body of pancreas.

View larger version (154K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —75-year-old woman with simple cyst of pancreas. Cyst was unchanged during 12-month follow-up. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in body of pancreas.

View larger version (78K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —75-year-old woman with simple cyst of pancreas. Cyst was unchanged during 12-month follow-up. This cyst (arrow, C) appears hyperintense compared with pancreas on diffusion-weighted image with b factor of 500 s/mm2 (C) and isointense relative to pancreas on diffusion-weighted image with b factor 1,000 s/mm2 (D).

View larger version (59K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —75-year-old woman with simple cyst of pancreas. Cyst was unchanged during 12-month follow-up. This cyst (arrow, C) appears hyperintense compared with pancreas on diffusion-weighted image with b factor of 500 s/mm2 (C) and isointense relative to pancreas on diffusion-weighted image with b factor 1,000 s/mm2 (D).

View larger version (116K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —75-year-old woman with simple cyst of pancreas. Cyst was unchanged during 12-month follow-up. Apparent diffusion coefficient map (ADC = 3.6 x 10–3 mm2/s).

View larger version (127K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —17-year-old girl with pancreatic pseudocyst. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in body of pancreas.

View larger version (113K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —17-year-old girl with pancreatic pseudocyst. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cyst in body of pancreas.

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —17-year-old girl with pancreatic pseudocyst. Cyst appears hyperintense compared with pancreas on diffusion-weighted image with b factor of 500 s/mm2 (C) and isointense relative to pancreas on image with b factor of 1,000 s/mm2 (D).

View larger version (86K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2D —17-year-old girl with pancreatic pseudocyst. Cyst appears hyperintense compared with pancreas on diffusion-weighted image with b factor of 500 s/mm2 (C) and isointense relative to pancreas on image with b factor of 1,000 s/mm2 (D).

View larger version (105K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2E —17-year-old girl with pancreatic pseudocyst. Apparent diffusion coefficient map (ADC = 3 x 10–3 mm2/s).

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —53-year-old woman with serous cystadenoma of pancreas. Coronal T2-weighted turbo spin-echo MR image shows cystic mass in head of pancreas.

View larger version (94K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —53-year-old woman with serous cystadenoma of pancreas. Cyst shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (B) and 1,000 s/mm2 (C).

View larger version (68K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —53-year-old woman with serous cystadenoma of pancreas. Cyst shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (B) and 1,000 s/mm2 (C).

View larger version (74K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —53-year-old woman with serous cystadenoma of pancreas. Apparent diffusion coefficient map (ADC = 2.7 x 10–3 mm2/s).

View larger version (151K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —54-year-old woman with mucinous cystadenoma of pancreas. Axial T2-weighted turbo spin-echo MR image shows cystic mass in tail of pancreas.

View larger version (88K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —54-year-old woman with mucinous cystadenoma of pancreas. Cyst (arrow) shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (B) and 1,000 s/mm2 (C).

View larger version (83K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —54-year-old woman with mucinous cystadenoma of pancreas. Cyst (arrow) shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (B) and 1,000 s/mm2 (C).

View larger version (65K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4D —54-year-old woman with mucinous cystadenoma of pancreas. Apparent diffusion coefficient map (ADC = 2.7 x 10–3 mm2/s).

View larger version (135K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —73-year-old woman with mucinous cystadenocarcinoma of pancreas. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cystic mass in body of pancreas.

View larger version (148K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —73-year-old woman with mucinous cystadenocarcinoma of pancreas. Axial T1-weighted fast-field echo (A) and T2-weighted turbo spin-echo (B) MR images show cystic mass in body of pancreas.

View larger version (61K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —73-year-old woman with mucinous cystadenocarcinoma of pancreas. Cyst (arrow, C) shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (C) and 1,000 s/mm2 (D).

View larger version (92K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —73-year-old woman with mucinous cystadenocarcinoma of pancreas. Cyst (arrow, C) shows higher signal intensity than pancreas on diffusion-weighted images with b factors of 500 s/mm2 (C) and 1,000 s/mm2 (D).

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5E —73-year-old woman with mucinous cystadenocarcinoma of pancreas. Apparent diffusion coefficient map (ADC = 2.8 x 10–3 mm2/s).

View larger version (8K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 6 —Scattergram distribution of cyst-to-pancreas signal intensity ratios of groups 1 () and 2 () on diffusion-weighted images with b factor 1,000 s/mm2.

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