Extrapancreatic neural plexus invasion by pancreatic carcinoma: characteristics on magnetic resonance imaging.
BACKGROUND
Our objective is to study the characteristics of extrapancreatic neural plexus invasion by pancreatic carcinoma on MR imaging.


METHODS
20 patients with both pancreatic carcinoma and extrapancreatic neural plexus invasion confirmed by pathology were recruited in this study. MR imaging was performed within 1 month before surgery. On MR images, signal intensity at the site of potential extrapancreatic neural plexus invasion, lymph nodes and tumor size were noted. The relationship of extrapancreatic neural plexus invasion to these findings was analyzed.


RESULTS
Signs of extrapancreatic neural plexus invasion were depicted on MR imaging in 80% of patients, which included streaky and strand-like signal intensity structure in fat tissue in 50% of patients and irregular masses adjacent to tumor in 30%. Signal intensity at invasion site was similar to that of pancreatic carcinoma. The frequencies of patients with vascular invasion and with lymph nodes larger than 5 mm were, respectively, 50% and 55%. Tumor diameter was 24 +/- 7 mm on MR imaging. Extrapancreatic neural plexus invasion was correlated with vascular invasion (r = 0.58, P < 0.005), slightly related with lymphadenopathy (r = 0.35, 0.1 > P > 0.05), but not related with tumor size.


CONCLUSIONS
MR imaging is useful to depict extrapancreatic neural plexus invasion by pancreatic carcinoma.
Zhang
Xiao Ming
XM
Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, People's Republic of China. zhangxm@nsmc.edu.cn
Mitchell
Donald G
DG
Witkiewicz
Agnes
A
Verma
Sachit
S
Bergin
Diane
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002277:Carcinoma / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000294:innervation* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies
D003287:Contrast Media; D019786:Gadolinium DTPA