Review Note
Last Update: 02/18/2024 05:30 AM
Current Deck: Part 2::1. Subsites::Gastrointestinal tract::Pancreatic cancer::Exocrine pancreas
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Fields:
Front
GI | Pancreas | Exocrine | 2.4 | Imaging appearance | Briefly describe the appearance of pancreatic cancer on abdominal ultrasound, CT, ERCP and MRI
Back
Appearance on imaging
Imaging modality | Appearance of pancreatic cancer | Sensitivity |
---|---|---|
Abdominal ultrasound | Hypoechoic, hypovascular solid mass with irregular margins; Dilated bile ducts may also be present | 95% for tumours >3cm; much lower for smaller tumours |
Abdominal CT | Ill-defined, hypoattenuating mass within the pancreas. Smaller lesions may be isoattenuating (difficult to identify, esp. non non-contrast CT); Tumour enhances poorly compared to adjacent normal pancreatic tissue and thus appears hypodense on arterial pahse scans, may become isodense on delayed scans; Secondary signs incl. "double duct sign" | Triple phase ("pancreatic protocol") CT most sensitive. 100% for >2cm; 75% for <2cm |
ERCP (endoscopic retrograde cholangiopancreatography) | Stricture in pancreatic duct. Obstruction/dilation of CBD+pancreatic duct (double duct sign); | May miss tumours in uncinate process, accessory duct and tail |
MRI | T1/T1 FS: Hypointense cf. normal pancreas; T1+C" Slower enhancement than normal pancreas; T2/FLAIR: not useful; MRCP: double duct sign may be seen |
Double duct sign: Dilation of both the pancreatic duct and common bile duct, seen in ~70% but not diagnostic. Can also be seen in 50% of ampullary carcinomas, and occasionally in benign adenomas and autoimmune pancreatitis
Further information, not for memorising (no card)
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