PANCREATIC ADENOCARCINOMA - COMBINATION OF MR-IMAGING, MR-ANGIOGRAPHYAND MR CHOLANGIOPANCREATOGRAPHY FOR THE DIAGNOSIS AND ASSESSMENT OF RESECTABILITY

The purpose of this study was to determine the possibility of integrat ing MR cholangiopancreatography (MRCP) and MR angiography (MRA) to con ventional MR images in the diagnosis and assessment of resectability o f pancreatic adenocarcinoma. Twenty-three patients with pancreatic ade nocarcinoma were prospectively examined with MR. Conventional MR image s were acquired in all patients. Three-dimensional MRCP and MRA images were acquired in all patients with suspected biliary and vascular inv olvement. Acquisition time was less than 45 mill in all cases. Images were independently evaluated by two radiologists, with final reading d ecided by consensus among readers. Diagnosis was confirmed with surger y in 16 patients and with percutaneous biopsy in 7. Concordance among readers was high with a kappa value of 0.83. Pancreatic adenocarcinoma was observed in all patients. Correct assessment of unresectability d ue to vascular involvement was found in 22 of 23 patients. Biliary obs truction was evident in 13 patients, involving the biliary and pancrea tic ducts in 9 and the biliary ducts only in 4. Technical advances per mit extensive use of MRI in the evaluation of abdominal pathologies. T he combination of MR imaging, MRCP, and MRA can provide sufficient inf ormation for the diagnosis and assessment of resectability of pancreat ic adenocarcinoma, which otherwise would require three different exams .