Table 2 Differences in epidemiology and morphology on MRCP of cystic pancreatic tumours
From: Magnetic resonance cholangiopancreatography: the ABC of MRCP
Serous cystadenoma | Mucinous cystic neoplasms | Intraductal mucinous neoplasm (IPMN) | |
|---|---|---|---|
Demographics | Typically older women >60 years | Typically younger women 30-50 years | Peak age 6th decade, no gender bias |
Site of tumour | Anywhere in the pancreas, especially the head | 75% in body/tail | Side branch type: usually pancreatic head/uncinate process, less frequently in the tail; tumour communicates with the main pancreatic duct |
Main duct type: segmental or diffuse involvement of the main pancreatic duct | |||
Morphology | >6 cysts (<2 cm each), thin septations, central scar (calcification), does not communicate with the pancreatic duct | Cysts >2 cm, unilocular or multilocular, does not communicate with the pancreatic duct | Side branch type: macrocystic or microcystic appearances |
Features of malignancy on MR denoted by thick septations, soft tissue nodules, and/or pancreatic duct dilatation | Main duct type: diffuse duct dilatation due to gross mucin production, micropapillary studding, pancreatic atrophy | ||
Average size | 5 cm | 6-10 cm | Larger size with malignant tumours |
Signal characteristics | Fluid signal | High signal intensity on T1 and T2 (mucin/blood) | High signal intensity on T1 (mucin), intermediate signal intensity on T2 |
Comments | Usually benign | Malignant in 50% | Side branch type: usually associated with benign adenomas |
Main duct type: malignant in 40% |