Congenital arteriovenous malformation of the pancreas: Its diagnostic features on images

To analyze diagnostic features on images of congenital arteriovenous malfor mation (AVM) of the pancreas, we analyzed the diagnostic findings in six pa tients with the disease, using gray-scale ultrasonography (US), color Doppl er US, computed tomography, and angiography and analyzed previously reporte d cases. AVM characteristic findings on images were multiple, small hypoech oic nodules on US, mosaic appearance of the lesion and pulsatile wave form in the portal vein on color Doppler US, conglomerated small nodular enhance ment of the lesion and early appearance of the portal vein on CT, and a rac emose network and early appearance of the portal vein on angiography. Five of the six patients underwent surgery, and all resected specimens were hist ologically found to be AVMs of the pancreas; however, one with developed po rtal hypertension at surgery died of repeated bleeding from esophageal vari ces. From analysis of total of 35 cases including our six cases, a mosaic a ppearance of the lesion was found in 100% and a pulsatile wave form in the portal vein in 77.8% on color Doppler US. Color Doppler US is noninvasive a nd useful for detecting congenital AVM of the pancreas at an early stage, p reventing the portal hypertension causing esophageal varices and their rupt ure.