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Contrast-enhanced CT demonstrates a diffusely enlarged (sausage-shaped) pancreas. Diffuse irregular narrowing of the main pancreatic duct, and stenosis of the intrapancreatic bile duct on endoscopic retrograde cholangiopancreatography (ERCP). Rare pancreatic calcification or cyst formation. Marked responsiveness to treatment with corticosteroids.
Abdominal imaging is associated with many potential uses for the different phases of contrast CT.The majority of abdominal and pelvic CT's can be performed using a single-phase, but the evaluation of some tumor types (hepatic/pancreatic/renal), the urinary collecting system, and trauma patients among others, may be best performed with multiple phases.
Pancreatic cysts may sometimes be definitively diagnosed based on imaging findings from an MRI or CT scan with contrast. However, sometimes additional imaging is required, such as an endoscopic ultrasound with or without fine needle aspiration or magnetic resonance cholangiopancreatography (MRCP). [ 1 ]
Pancreatic cancer is usually staged following a CT scan. [34] The most widely used cancer staging system for pancreatic cancer is the one formulated by the American Joint Committee on Cancer (AJCC) together with the Union for International Cancer Control (UICC).
While MRI is superior to CT for imaging, both of the primary tumor and evaluation of metastases, CT is more readily available. Notably, while many malignant lesions are hypodense in contrast-enhanced studies, the liver metastases of PNETs are hypervascular and readily visualized in the late arterial phase of the post-contrast CT study.
A pancreatic pseudocyst is a circumscribed collection of fluid rich in pancreatic enzymes, blood, and non-necrotic tissue, typically located in the lesser sac of the abdomen. Pancreatic pseudocysts are usually complications of pancreatitis , [ 5 ] although in children they frequently occur following abdominal trauma .
A contrast-enhanced CT scan is usually performed more than 48 hours after the onset of pain to evaluate for pancreatic necrosis and extrapancreatic fluid as well as predict the severity of the disease. CT scanning earlier can be falsely reassuring. [34] ERCP or an endoscopic ultrasound can also be used if a biliary cause for pancreatitis is ...
On MRI scan, there is a low T1 signal due to inflammation, fibrosis, focal lesions, and calcifications. In those who are given a contrast agent, there would be a higher T1 signal with late gadolinium enhancement due to compression from the fibrotic areas. The overall thickness of the pancreas will be reduced. [12]