CT and MRI/MRCP

The roles of multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI)/MR cholangiopancreatography (MRCP) in the diagnosis of intraductal papillary mucinous neoplasm (IPMN) include the detection, characterization, evaluation of surgical anatomy, and imaging follow-up. MRI/MRCP is superior to MDCT in the detection and characterization of IPMN. Since branch duct IPMN (BD-IPMN) is relatively common, imaging findings of BD-IPMN may overlap those of other pancreatic cysts. Especially when MDCT or MRI/MRCP fail to demonstrate communication with the main pancreatic duct (MPD), the differential diagnosis between BD-IPMN and oligocystic serous cystic neoplasm (SCN) may be difficult. The likelihood of malignancy has been mainly assessed by indirect findings related to tumor volume and the degree of mucin hypersecretion, including the presence or absence of mural nodule, cyst size, and MPD diameter. MDCT compensates for the drawbacks of MRI, especially in cases where the image quality is degraded. Due to its higher spatial resolution, MDCT may be helpful in demonstrating pancreatic parenchymal abnormalities indicative of invasive carcinoma. In addition, MDCT is a reliable modality in evaluating preoperative vascular anatomy. Furthermore, curved planar reformation images created along the course of the MPD are visually demonstrable. MRI/MRCP is the preferred modality for follow-up imaging because of its lacking in ionizing radiation. MDCT is being utilized adjunctively in the imaging surveillance for pancreatic ductal adenocarcinoma (PDAC) and extrapancreatic diseases.