MR imaging in the diagnosis of pancreatic disease

MR imaging examinations of 20 patients with normal pancreas and of 38 patients with suspected pancreatic disease were analyzed retrospectively to evaluate the ability of MR imaging to depict the normal and abnormal pancreas, establish MR criteria for various pancreatic diseases, determine if MR imaging can distinguish among various pancreatic diseases, and compare the usefulness of MR imaging with CT. In all 20 patients with normal pancreas and in 34 of the 38 patients with suspected pancreatic disease excellent or good evaluation of the pancreas was achieved. A 0.35-T magnet (Diasonics MT/S) was used, and both T1- and T2-weighted images were needed. T1 and T2 relaxation times and MR signal intensities showed no specific pattern to allow consistent differentiation between normal and diseased pancreatic tissue or to distinguish between tumor and inflammation. In the 29 patients in whom MR and CT images could be compared, MR imaging and CT provided equivalent information in 20 (69%). In 4 patients (14%), MR imaging added information, and in 5 patients (17%) of cases, MR imaging yielded less information than CT. MR imaging of the pancreas was found to be superior to CT in selected instances, such as in the staging of pancreatic neoplasms (n = 4) and in the evaluation of pancreatic disease after surgery (n = 3). We conclude that, at present, MR imaging should not be used as the screening method for pancreatic disease but should be reserved as an adjunct when the information provided by CT is insufficient.