Interactive Transcript
0:01
So this is another case here with the
0:03
cystic region in the pancreas, and we are
0:06
trying to characterize what exactly it is.
0:08
As we move here, we can see that
0:10
there are multiple lesions; those
0:12
are arising from the side branches.
0:14
So they are classical side-branch IPMNs; we can
0:16
demonstrate the communication with the main duct.
0:19
But as we go further to the pancreatic
0:22
head, we see this huge lesion with
0:26
multiple lobulated outlines and central
0:29
scar, which is T2-weighted hypointense.
0:32
And that shows tiny cysts inside,
0:35
packed together very closely,
0:37
and separated by thin septa inside.
0:41
So this looks like a classical honeycombed
0:42
appearance with centerless scar.
0:46
And if we have a CT scan, possibly we
0:47
will see calcifications here.
0:49
But that can be sometimes seen on
0:52
T1-weighted images if we can find.
0:56
So there is some kind of artifact
0:57
here that can be calcification.
1:01
But tough to predict without,
1:02
without seeing CT here.
1:05
And as we move to post-contrast images, we can see
1:10
those thin separations are minimally enhancing,
1:13
but we can actually appreciate that honeycombed
1:16
appearance very well on post-contrast images.
1:19
And this is the central scar,
1:20
which is also enhancing.
1:23
This is delayed phase, more enhancement of
1:27
the central scar with some non-enhancing
1:30
foci; those are likely calcifications.
1:33
So this is a classical textbook picture of
1:36
a serious tumor in the pancreas with
1:40
honeycombing appearance and central scarring,
1:42
situated in the pancreatic head or proximal
1:45
pancreas; and then we have some coexisting
1:49
side-branch IPM in the same patient.
© 2024 MRI Online. All Rights Reserved.