Mucinous cystadenomas and intraductal papillary mucinous tumors of the pancreas in magnetic resonance cholangiopancreatography

Background and Study Aims: In mucin-producing tumors of the pancreas, diagn osis using endoscopic retrograde cholangiopancreatography (ERCP) is limited to cystic formations that communicate with the main pancreatic duct. Magne tic resonance cholangiopancreatography (MRCP) is a new sophisticated method which is currently under evaluation. The authors describe the usefulness o f MRCP in diagnosis of mucin-producing tumors, Patients and Methods: Six patients with mucin-producing tumors were investi gated using MRCP and ERCP, Imaging was compared with surgery and histopatho logical examinations. Results: Three patients were found to have mucinous cystadenomas (MC), two patients had intraductal papillary mucinous tumors (IPMT) and one patient h ad a cystadenocarcinoma. MRCP demonstrated the cystic formations in all pat ients. Magnetic resonance imaging (MRI) showed contrast-mediated enhancemen t of the cystic wall in patients with MC, and visualized the pancreatic duc ts completely in patients with IPMT. ERCP failed to visualize the cystic le sion in one patient with MC of the pancreatic tail, Furthermore. ERCP showe d evidence of IPMT in dilated main ducts with multiple filling defects but did not visualize the ducts completely. Conclusions: MRCP provides visualization of pancreatic ducts, extraductal v ariations, and cystic formations more completely than ERCP does, It avoids complications seen in ERCP, MRCP may replace ERCP in the Evaluation of muci n-producing tumors of the pancreas.