[Value of dynamic enhanced magnetic resonance in diagnosis of pancreatic carcinoma and endocrine tumors].
OBJECTIVE
To explore the value of dynamic enhanced magnetic resonance (MR) in diagnosis of pancreatic carcinoma and endocrine tumors.


METHODS
Twenty-two patients with pancreatic carcinoma and 9 patients with pancreatic endocrine tumors underwent routine MR scanning and dynamic contrast enhanced MR examination before they underwent operation.


RESULTS
No tumor image was seen in 4 of the 22 patients with pancreatic carcinoma by routine MR scanning. Fat-saturated T(1)-weighted imaging (FS-T(1) WI) showed that 11 of them were hyposignal, 6 slightly hyposignal, and 1 isosignal; and fat-saturated T(2)-weighted imaging (FS-T(2) WI) showed that 5 were hypersignal, 7 slightly hypersignal, 5 isosignal, 1 slightly hyposignal, and 13 with heterogeneous signals. After dynamic MR imaging no tumor was enhanced in the arterial phase (AP); and all the tumors were obviously enhanced during the pancreatic phase (PP) and portal venous phase (PVP), 5 of which showed isosignal intensity, 10 slightly hyposignal intensity, and 3 hyposignal intensity. Four of the 5 cases with small pancreatic carcinoma were demonstrated as isosignal and one was slightly hyposignal. During the delayed enhancement phase (DEP) the signal intensity of the tumors became slightly weaker. No tumor image was seen in 14 of the 9 patients with pancreatic endocrine tumors by routine MR scanning. FS-T(1) WI showed that 5 of them were hyposignal, and 3 slightly hyposignal; and FS-T(2) WI showed that 2 were hypersignal, 4 slightly hyposignal, and 2 isosignal. After dynamic MR imaging 2 cases were moderately enhanced and 6 cases mildly enhanced during AP, and all pancreatic endocrine tumors were obviously enhanced during PP and PVP, with isosignal intensity in 2 cases, slightly hyposignal intensity in 1 case, and slightly hypersignal intensity in 5 cases. Peritumor thin-walled enhancement was seen in 6 cases.


CONCLUSIONS
Dynamic enhanced MR has a certain value in the diagnosis of pancreatic carcinoma and endocrine tumors. Pancreatic carcinoma shows various enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form not surpassing that of normal pancreatic tissue. Pancreatic endocrine carcinoma shows obvious enhanced forms by dynamic enhanced magnetic resonance, the degree of the greatest enhanced form surpassing that of normal pancreatic tissue. Peritumor thin-walled enhancement is a characteristic feature of pancreatic endocrine carcinoma.
Lu
Guang-ming
GM
Department of Medical Imaging, Jinling Hospital, Nanjing 210002, China.
Wang
Zhong-qiu
ZQ
Zheng
Ling
L
Wang
Jun-peng
JP
Qiu
Xiao-ming
XM
Tang
Xiao-jun
XJ
D000328:Adult; D000368:Aged; D018273:Carcinoma, Islet Cell / Q000175:diagnosis; D004701:Endocrine Gland Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted