Evaluation of the pancreatic malignancy with MRI & MDCT modalities

Abstract

Background:Detection of pancreatic abnormality by routine noninvasive radiological method namely plain radiography and gastrointestinal barium studies is possible but these tests are insensitive and nonspecific. In earlier era more invasive tests like retroperitoneal air insufflations with tomography used never achieved wide spread clinical application and isotope scan proved disappointing owing to their false positive rates. Material & Methods:The present retrospective study was conducted at department of Department of Radiology at MRI Centre, M.B. Govt. Hospital, Udaipur. The study duration was December 2012 to November 2014. The study group of 100 patients, with suspected pancreatic diseases were examined using either MDCT scan or MRI or both as prime diagnostic modality.Results: In the present study, Pancreatic carcinoma is a hypo vascular mass so it does not enhance at all or show a mild enhancement on post contrast study. In this study out of 14 cases, 14 cases showed mild post contrast enhancement and 2 cases showed no enhancement at all. on CECT examination, out of 10 cases of head mass, 8 cases were hypo dense and 2 were Isodense and showed dilated MPD in 9 cases 90.00% which were most common finding followed by dilated CBD in 8 cases (80.00%) and invasion of other organs in 2 cases (20%). On MRI examination, out of 4 cases of head carcinoma, 3 appeared hyperintense & 1 appeared hypointense and showed dilatation of MPD & CBD in all cases and invasion of organ in one case. Out of 14 cases of head carcinoma, 4 (28.57%) cases showed distal metastasis in liver. Out of 7 cases of body-tail mass, six appeared hypo dense and one appeared on NCCT. Distant metastasis and dilated MPD were found in 4 cases and CBD were dilated in any one case of body mass. Conclusion: We concluded from the present study that Dual-phasic contrast-enhanced MDCT in the pancreatic parenchymal and the venous phase is the method of choice for detection and staging of pancreatic cancer, inflammatory lesions and its vascular complications. For detection of small, hyper vascular neuroendocrine tumors, no single imaging method will reveal all tumors. In this respect, MDCT and MRI are complementary methods.