Diagnostic Ultrasound - Abdomen and Pelvis

Intraductal Papillary Mucinous Neoplasm (IPMN)
Diagnoses: Pancreas
(Left) Axial T2WI MR
demonstrates grape-like cystic
lesions st throughout the
pancreatic body and tail with
a multiloculated cystic lesion
in the neck of the
pancreas. Note the mildly
dilated pancreas duct ſt,
which appeared to
communicate with some of
the lesions (not shown).
(Right) Endoscopic ultrasound
in the same patient
demonstrates multiple
clustered, thin-walled, cystic
lesions ſt involving the entire
pancreas, consistent with
extensive side-branch-type
IPMN.
(Left) Axial CT demonstrates a
thin-walled, elongated,
nonenhancing, cystic lesion ſt
in the head of the pancreas.
(Right) Axial T2WI MR in the
same patient better
demonstrates curvilinear
communication st between
the cystic lesion and the mildly
dilated main pancreatic duct
ſt consistent with a sidebranch-type
IPMN.
(Left) Direct endoscopic
visualization shows a classic
bulging "fish eye" papilla
extruding mucin,
pathognomonic for IPMN.
(Right) Endoscopic ultrasound
demonstrates a large cystic
mass in the head of the
pancreas, in continuity with a
very dilated pancreatic duct
(not shown). Note the mural
nodularity ſt, a worrisome
finding for malignancy.
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