Mucinous nonneoplastic cyst of the pancreas: CT and MRI appearances
Kousei Ishigami1, Akihiro Nishie2, Naoki Mochidome3
1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. ishigami@radiol.med.kyushu-u.ac.jp.
Purpose:
The purpose of this retrospective study was to evaluate imaging features of mucinous nonneoplastic cyst (MNNC) of the pancreas.
Materials And Methods:
Three (0.9%) patients with MNNC of the pancreas were found in 335 surgically resected pancreatic cystic lesions. Three MDCT and two MRI/MRCP studies were retrospectively reviewed.
Results:
Three cases of MNNC were found in the pancreatic neck, body, and tail, respectively. All the three cases were multilocular without communication with the main pancreatic duct (MPD), although upstream MPD dilatation was seen in two of the three cases. The signal intensity of the cyst fluid was low on T1-weighted, high on T2-weighted, and low on diffusion-weighted images. Cyst wall was thin in two cases, and the remaining case with obstructive pancreatitis showed visible cyst wall enhancement.
Conclusion:
Imaging findings of MNNC of the pancreas were nonspecific without communication with the MPD. Cyst wall is typically thin without visible enhancement.
Insights
Mucinous nonneoplastic cysts (MNNC) of the pancreas present nonspecific imaging features. These pancreatic cysts lack main pancreatic duct communication and typically have thin cyst walls without enhancement.
Area of Science:
- Gastroenterology
- Radiology
- Oncology
Background:
- Pancreatic cystic lesions are increasingly detected.
- Mucinous nonneoplastic cysts (MNNC) represent a subset of these lesions.
- Accurate imaging characterization is crucial for management.
Purpose of the Study:
- To evaluate the imaging features of pancreatic MNNC.
- To correlate imaging findings with histopathological diagnoses.
- To improve the diagnostic accuracy of MNNC on medical imaging.
Main Methods:
- Retrospective review of 335 surgically resected pancreatic cystic lesions.
- Analysis of three cases diagnosed as MNNC.
- Review of multi-detector computed tomography (MDCT) and magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) studies.
Main Results:
- MNNC were identified in 0.9% of resected pancreatic cysts.
- All three MNNC cases were multilocular and lacked communication with the main pancreatic duct (MPD).
- Upstream MPD dilatation was observed in two cases. Cyst fluid showed low T1, high T2, and low diffusion-weighted signal intensity. Thin cyst walls were typical, with enhancement seen in one obstructive case.
Conclusions:
- Imaging findings of pancreatic MNNC are nonspecific.
- Absence of communication with the MPD is a key feature.
- Typically thin cyst walls without enhancement are characteristic, but exceptions exist in cases with complications like obstructive pancreatitis.
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