Purpose: This study was aimed to integrating MR CholangioPancreatography (MRCP) and MR Angiography (MRA) to conventional MR images in the diagnosis and resectability assessment of pancreatic adenocarcinoma.
Material and methods: Twenty-three consecutive patients with pancreatic adenocarcinoma (16 in the head and 7 in the body-tail region) were examined with MR. Conventional MR, 3D MRCP and venous and arterial MRA images were acquired to assess biliary and vascular involvement. Acquisition time never exceeded 40-45 minutes. The images were independently studied by two radiologists and the final reading was decided upon consensus among readers. Sixteen patients underwent surgery.
Results: The diagnosis was confirmed at surgery in 16 patients and at percutaneous biopsy in 7. Interreader agreement was considered high, with .83 interobserver variability. Pancreatic adenocarcinoma was found in all patients examined. Unresectability because of vascular involvement was correctly assessed in all patients but 1. Biliary obstruction was demonstrated in 13 patients, involving the biliary and pancreatic ducts in 9 and the biliary ducts only in 4.
Conclusion: Technical advances now permit the extensive application of MRI to the study of abdominal conditions. The combination of MRI, MRCP and MRA can provide most of the information needed for the diagnosis and resectability assessment of pancreatic adenocarcinoma, which can otherwise be obtained only performing three different exams.