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Annular Pancreas on MRI

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So here we have a case, uh, adult patient

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here, which is presenting with pain in abdomen.

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And as we scroll through the coronal

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images on T2-weighted sequences, we can see the

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main pancreatic duct is draining where it is

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expected to, the major papilla, along with the CVD.

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And the pancreas is showing a normal

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homogeneous pattern, which is expected

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on T2 with lobulations present.

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But as soon as we scroll further, we

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can see there is some tissue outside the

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lateral wall of the duodenum as well.

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And that looks kind of hazy here,

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that gives a suspicion and then we

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can see the duct actually within that

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tissue, which is encircling the duodenum.

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And that raises the suspicion that it

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is possibly a case of annular pancreas.

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What we will do here, we will pick up axial

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and try to find if it is a real finding.

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And we see again the tissue is present, so this is

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the duodenal lumen and tissue is present outside.

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On T2-weighted fat suppress images,

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the contrast between the fat-suppressed

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retroperitoneal fat itself is not great.

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So sometimes these findings are not really well

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seen, but this case is actually very classical.

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We can see the entire ring and if you

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really have a doubt still, we can go

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to the post-contrast images and see

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if there is real tissue there or not.

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And we can see the duodenal lumen is present here

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and that enters the parenchyma and then we

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see the parenchymal tissue is going outwards

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towards the lumen and that confirms that it is.

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See, we can see here, the tissue is outside

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the duodenal wall and the lumen, and that is

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a classical presentation of annular pancreas.

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In this patient, we have seen some complex cystic

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lesions in the splenic dome as well, and they

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are complex, and they are showing multilocules,

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there is some enhancing septation inside, and

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that is basically lymphangioma of the spleen,

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that is incidentally seen in this patient.

Report

Faculty

Neeraj Lalwani, MD, FSAR, DABR

Professor and Chief of Abdominal Radiology

Montefiore Medical Center, New York

Tags

Pancreas

MRI

Congenital

Body

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