Published online Nov 28, 2015. doi: 10.4329/wjr.v7.i11.361
Peer-review started: April 28, 2015
First decision: August 4, 2015
Revised: September 8, 2015
Accepted: October 1, 2015
Article in press: October 8, 2015
Published online: November 28, 2015
Pancreatic ductal adenocarcinoma is the most common malignant tumor of the pancreas. The remaining pancreatic tumors are a diverse group of pancreatic neoplasms that comprises cystic pancreatic neoplasms, endocrine tumors and other uncommon pancreatic tumors. Due to the excellent soft tissue contrast resolution, magnetic resonance imaging (MRI) is frequently able to readily separate cystic from noncystic tumors. Cystic tumors are often easy to diagnose with MRI; however, noncystic non-adenocarcinoma tumors may show a wide spectrum of imaging features, which can potentially mimic ductal adenocarcinoma. MRI is a reliable technique for the characterization of pancreatic lesions. The implementation of novel motion-resistant pulse sequences and respiratory gating techniques, as well as the recognized benefits of MR cholangiopancreatography, make MRI a very accurate examination for the evaluation of pancreatic masses. MRI has the distinctive ability of non-invasive assessment of the pancreatic ducts, pancreatic parenchyma, neighbouring soft tissues, and vascular network in one examination. MRI can identify different characteristics of various solid pancreatic lesions, potentially allowing the differentiation of adenocarcinoma from other benign and malignant entities. In this review we describe the MRI protocols and MRI characteristics of various solid pancreatic lesions. Recognition of these characteristics may establish the right diagnosis or at least narrow the differential diagnosis, thus avoiding unnecessary tests or procedures and permitting better management.
Core tip: In addition to pancreatic ductal adenocarcinoma other solid pancreatic lesions occur. Less common solid primary pancreatic tumors and non-neoplastic disease processes that may be diagnosed with relatively high specificity employing magnetic resonance imaging (MRI). The radiologist must be familiar with their MRI appearance to correctly diagnose them, or suggest them in the differential diagnosis when appropriate, since it may change substantially the approach, prognosis and patient management.