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Diagn Interv Imaging. 2019 Mar 4. pii: S2211-5684(19)30033-6. doi: 10.1016/j.diii.2019.02.003. [Epub ahead of print]

MR imaging features of pancreatic acinar cell carcinoma.

Author information

1
Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
2
Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France; UMR Inserm 965, 2, rue Amboise-Paré, 75010 Paris, France.
3
Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France; Department of Pathology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
4
Department of Radiology, Hôpital Robert-Debré, 11, boulevard Pasteur, 51092 Reims, France.
5
Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France.
6
Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France; Department of Abdominal surgery, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
7
Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France; Department of Gastroenterology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
8
Department of Abdominal & Interventional Radiology, Hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Descartes Paris 5, Sorbonne Paris Cité, rue de l'École-de-Médecine, 75006 Paris, France; UMR Inserm 965, 2, rue Amboise-Paré, 75010 Paris, France. Electronic address: anthony.dohan@aphp.fr.

Abstract

PURPOSE:

This study aimed to report the magnetic resonance imaging (MRI) features of acinar cell carcinoma (ACC) of the pancreas including diffusion-weighted MRI findings.

MATERIALS AND METHODS:

The MRI examinations of five patients (3 men, 2 women; median age, 61years) with histopathologically proven ACC of the pancreas were retrospectively reviewed. MR images were analyzed qualitatively (location, shape, homogeneity, signal intensity, vascular involvement and extrapancreatic extent of ACC) and quantitatively (tumor size, apparent diffusion coefficient [ADC] and normalized ADC of ACC).

RESULTS:

All ACC were visible on MRI, presenting as an oval pancreatic mass (5/5; 100%), with moderate and heterogeneous enhancement (5/5; 100%), with a median transverse diameter of 43mm (Q1, 35; Q3, 82mm; range: 30-91mm). Tumor capsule was visible in 4/5 ACC (80%) and Wirsung duct enlargement in 2/5 ACC (40%). On diffusion-weighted MRI, all ACC (5/5; 100%) were hyperintense on the 3 b value images. Median ADC value of ACC was 1.061×10-3mm2/s (Q1, 0.870×10-3mm2/s; Q3, 1.138×10-3mm2/s; range: 0.834-1.195×10-3mm2/s). Median normalized ADC ratio of ACC was 1.127 (Q1, 1.071; Q3, 1.237; range: 1.054-1.244).

CONCLUSIONS:

On MRI, ACC of the pancreas presents as a large, oval pancreatic mass with moderate and heterogeneous enhancement after intravenous administration of a gadolinium chelate, with restricted diffusion and a median ADC value of 1.061×10-3mm2/s on diffusion-weighted MRI. Further studies however are needed to confirm our findings obtained in a limited number of patients.

KEYWORDS:

Acinar cell carcinoma of the pancreas; Diffusion-weighted MR imaging; MR imaging (MRI); Pancreatic neoplasms; Tissue characterization

PMID:
30846400
DOI:
10.1016/j.diii.2019.02.003

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