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European Radiology

, Volume 26, Issue 5, pp 1348–1358 | Cite as

Hypervascular solid-appearing serous cystic neoplasms of the pancreas: Differential diagnosis with neuroendocrine tumours

  • Hye Sun Park
  • So Yeon KimEmail author
  • Seung-Mo Hong
  • Seong Ho Park
  • Seung Soo Lee
  • Jae Ho Byun
  • Jin Hee Kim
  • Hyoung Jung Kim
  • Moon-Gyu Lee
Gastrointestinal

Abstract

Purpose

To describe imaging findings of arterial hypervascular solid-appearing serous cystic neoplasms (SCNs) of the pancreas on CT and MR and determine imaging features differentiating them from neuroendocrine tumours (NETs).

Materials and methods

We retrospectively identified 15 arterial hypervascular solid-appearing SCNs and randomly chose 30 size-matched pancreatic NETs. On CT, two radiologists in consensus assessed the size, morphology, and CT attenuation. On MR, predominant signal intensity and the amount of the cystic component on T2-weighted images and ADC maps were evaluated and compared using Fisher’s exact and Student’s t-test.

Results

The mean SCN size was 2.6 cm (range, 0.8–8.3). The CT findings were similar between the two tumours: location, shape, margin, and enhancement pattern. SCNs were significantly more hypodense on non-enhanced CT images than NETs (P = .03). They differed significantly on MR: bright signal intensity (P = .01) and more than a 10 % cystic component on T2-weighted images (P = .01) were more common in SCNs than in NETs. All SCNs showed a non-restrictive pattern on the ADC map, while NETs showed diffusion restriction (P < .01).

Conclusion

Arterial hypervascular solid-appearing SCNs and NETs share similar imaging features. Non-enhanced CT and MR images with T2-weighted images and ADC maps can facilitate the differentiation.

Key points

Frequency of hypervascular solid-appearing SCNs was 7.3 % among surgically confirmed SCNs.

Hypervascular solid-appearing SCN of the pancreas can mimic pancreatic NETs.

Unenhanced CT and MR features help to differentiate the two tumours.

Keywords

Pancreatic neoplasms Diagnosis Diagnostic imaging Multidetector computed tomography Magnetic resonance imaging 

Abbreviations and acronyms

ADC

Apparent diffusion coefficient

CT

Computed tomography

DW

Diffusion-weighted

MR

Magnetic resonance

NET

Neuroendocrine tumours

SCN

Serous cystic neoplasms

Notes

Acknowledgements

The scientific guarantor of this publication is Moon-Gyu Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding from Grant #2012R1A1A1012731 to the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology, Korea. The authors have no financial association that may pose a conflict of interests with the submitted manuscript. Seong Ho Park (one of the authors) has significant statistical expertise. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. None of our study subjects have been previously reported.

Methodology: retrospective, diagnostic or prognostic study, performed at one institution.

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Copyright information

© European Society of Radiology 2015

Authors and Affiliations

  • Hye Sun Park
    • 1
  • So Yeon Kim
    • 1
    Email author
  • Seung-Mo Hong
    • 2
  • Seong Ho Park
    • 1
  • Seung Soo Lee
    • 1
  • Jae Ho Byun
    • 1
  • Jin Hee Kim
    • 1
  • Hyoung Jung Kim
    • 1
  • Moon-Gyu Lee
    • 1
  1. 1.Department of Radiology and Research Institute of RadiologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea
  2. 2.Department of PathologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulKorea

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