Pancreatic disease: prospective comparison of CT, ERCP, and 1.5-T MR imaging with dynamic gadolinium enhancement and fat suppression.
New magnetic resonance (MR) imaging techniques possess features desirable for imaging the pancreas. Computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) were prospectively compared with breath-hold fast low-angle shot (FLASH) and fat-suppressed spin-echo techniques before and after enhancement with gadopentetate dimeglumine. Thirty-five patients underwent ERCP, CT, and/or MR imaging studies within a 1-month period. Correlation with surgical findings, histologic findings, or clinical and/or imaging follow-up was obtained in all cases. Quantitative measurements of pancreas, pancreas minus pancreatic lesion, and pancreas minus fat signal-to-noise ratios (SNRs) were performed on MR images. The highest measurements of pancreas minus pancreatic tumor SNR were on gadolinium-enhanced, fat-suppressed images (8.9 +/- 3.4). The 1-second postcontrast FLASH images most reliably showed enhancement of normal pancreatic tissue. Nonenhanced FLASH images depicted peripancreatic fluid and inflammatory changes most successfully. The findings from this study suggest MR imaging is effective for imaging inflammatory and neoplastic pancreatic disease and may be superior to CT.
Semelka
R C
RC
Department of Radiology, St Boniface General Hospital MRI Facility, Winnipeg, Man, Canada.
Kroeker
M A
MA
Shoenut
J P
JP
Kroeker
R
R
Yaffe
C S
CS
Micflikier
A B
AB
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003287:Contrast Media; D004338:Drug Combinations; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009942:Organometallic Compounds; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D004369:Pentetic Acid; D011446:Prospective Studies; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA