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The papillary process: a pseudotumor on coronal and sagittal MRI
R S Kasat1, K D Hopper, R Mahraj
1College of Medicine, Penn State University, Hershey 17022.
Magnetic Resonance Imaging
|January 1, 1993
Summary
The papillary process of the caudate lobe commonly extends posterior to the inferior vena cava (IVC), potentially mimicking masses on MRI. Understanding this common anatomical variant is key to accurate radiological interpretation.
Area of Science:
- Radiology
- Anatomy
- Medical Imaging
Background:
- The papillary process of the caudate lobe is an anatomical structure within the liver.
- Its posterior extension can create diagnostic challenges on cross-sectional imaging.
- Misinterpretation as pathology can lead to unnecessary investigations.
Purpose of the Study:
- To determine the frequency of posterior papillary process extension.
- To assess the potential for misdiagnosis on MRI.
- To highlight this common anatomical variant for radiologists.
Main Methods:
- Retrospective analysis of contrast-enhanced axial CT scans.
- Evaluation of 113 adult patients.
- Assessment of papillary process relationship to the inferior vena cava (IVC) and aorta.
Main Results:
- 97% of patients showed papillary process extension posterior to the IVC's anterior margin.
- 66% had >50% papillary process overlap with the IVC.
- 12% demonstrated the papillary process extending behind the IVC.
Conclusions:
- Posterior extension of the papillary process is a frequent anatomical variant.
- This variant can mimic a separate soft tissue mass on coronal and sagittal MRI.
- Awareness of this variant is crucial for accurate MRI interpretation and avoiding misdiagnosis.