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Which imaging modality is best for detecting and staging pancreatic cancer?  MDCT obtained in the pancreatic parenchymal phase with MPRs is the best imaging modality for detecting lesions as small as 2-3 mm and providing a detailed evaluation of the pancreatic duct. MDCT is better than US at evaluating adjacent spread or nodal involvement. Overlying …

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Imaging findings of pancreatic ductal adenocarcinoma A. Pancreatic enlargement is usually focal and best appreciated in the pancreatic body and tail. Diffuse enlargement is often secondary to pancreatitis caused by the neoplasm. B. Enlargement and distortion of the pancreatic contour or shape are the most frequent findings of pancreatic cancer. C. Difference in density or echogenicity are present. …

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Role of CT and US in assessing the delayed complications of pancreatitis A. Ten percent to 20% of patients with acute pancreatitis and fluid collections develop pseudocysts after 4 to 6 weeks. Most pseudocysts smaller than 5 cm in diameter regress spontaneously. Drainage may be indicated for pseudocysts (1) failing to resolve after 6 weeks; (2) …

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How can acute pancreatitis be distinguished from chronic pancreatitis on imaging? Acute US: US may be limited in the initial evaluation of acute pancreatitis because of overlying bowel gas, resulting in incomplete visualization of the pancreas and underestimation of the extent of peripancreatic fluid collections compared with CT. If pancreatic visualization is not impeded by bowel …

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Radiologic work up of suspected biliary tree obstruction US: US is the screening examination of choice for suspected biliary ductal disease. Doppler can readily differentiate biliary ducts from vasculature in the portal triad. A CBD diameter larger than 6 mm is more sensitive than dilated intrahepatic ducts in assessing early or partial biliary obstruction; however, the …

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What is magnetic resonance cholangiopancreatography (MRCP) and how does it compare to endoscopic retrograde cholangiopancreatography (ERCP)?  MRCP is a noninvasive way to evaluate the hepatobiliary tract using heavily T2-w images. MRCP can reliably demonstrate the CBD, the pancreatic duct, the cystic duct, and aberrant hepatic ducts, and can differentiate dilated from normal ducts. MRCP exceeds …

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Differential imaging features seen in the common causes of biliary obstruction A. Intrahepatic ductal dilatation (> 2 mm) with a normal common bile duct (CBD) suggests an intrahepatic mass or abnormality. Dilatation of the pancreatic duct typically localizes the obstruction to the pancreatic or ampullary level. B. An abrupt transition from a dilated to a narrowed or …

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