Evaluation by 3D and colour Doppler sonography of a cystic tumour located at the head of pancreas.

Aim: Differential diagnosis of cystic lesions in the abdomen may be very di fficult. We present the clinical manifestation and the diagnostic steps of a rare case of an aneurysm of the gastroduodenal artery mimicking a cystic lesion. We also discuss the imaging methods we used to verify the diagnosis such as colour Doppler sonography and 3D-sonography. Method and Patient: A 42-year old woman with chronic pancreatitis was admitted to our hospital a fter an extended diagnostic program (sonography, computed tomography and la paroscopy) with the diagnosis of a pancreatic pseudocyst with vascular arro sion. Using conventional sonography we found a cystic lesion of 5 x 5 cm di ameter with parietal deposits between pancreas and coeliac trunk. After col our Doppler sonography we found an arterial jet in the cystic tumor; initia lly the source of the jet seemed to be the hepatic artery. We referred the patient to our department of radiology with the diagnosis of hepatic artery aneurysm. The aneurysm was confirmed by the angiography and was embolised with coils in the same session. However, the source of the aneurysm was not the hepatic, but the gastroduodenal artery. By postangiographical 3D-sonog raphy we could clearly reconstruct the relation of the aneurysm to the gast roduodenal artery. Conclusion: Colour Doppler sonography should be the firs t imaging tool for clarifying cystic lesions in the abdomen. 3D-sonography is a reliable and useful method to identify visceral vessels of the abdomen . Nowadays the "gold standard" angiography should preferably be used as a t herapeutic procedure.