الفهرس 
ANATOMY OF THE PANCREASOnly 14 pages are availabe for public view
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Abstract
Pancreatic cancer is one of the most lethal human cancers and continues to be a major unsolved health problem at the start of the 21st century as most of cases are unresectable at the time of diagnosis. Early detection promises a better prognosis.
The superior soft-tissue contrast of MRI compared with CT is useful in the detection and characterization of non–contour-deforming pancreatic masses. MRI compared with CT may be more sensitive in the detection of distant disease, better for defining appropriate surgical candidates, and better for characterizing small liver metastases and peritoneal and omental metastases.
Over the past decade, advancements in MRI techniques have resulted in a dramatic improvement in the ability of the radiologist to analyze pancreatic neoplasms. These advancements include the introduction of faster breath-hold sequences to limit motion artifact, the development of improved protocols for optimization of pancreatic contrast enhancement, the use of MRCP to evaluate the relationship of pancreatic lesions to the pancreaticobiliary system, and the use of MRA to evaluate the relationship of pancreatic masses to the adjacent vasculature.
The use of these techniques results in accurate diagnosis of malignant pancreatic lesions with 95% sensitivity and specificity. Of similar importance, positive and negative predictive values of cancer non-resectability as high as 90% and 83%, respectively, can be achieved.
Emerging techniques such as DWI and MRS may prove to advance the power of MRI as a diagnostic tool in the imaging of pancreatic neoplasms.
DWI can be useful for visual detection of pancreatic cancer and the ADC measurements may help as a supplement to other imaging modalities to differentiate between pancreatic carcinoma and benign mass-forming pancreatitis.
MRS has been used as a tool in the differentiation of pancreatic cancer from chronic focal pancreatitis by analyzing the lipid content of pancreatic tissue.
Recent advances in magnet design and MR system technology coupled with the development of fast gradient-echo pulse sequences have contributed to the increasing interest in interventional MRI. Minimally invasive diagnostic and therapeutic image-based intervention can now be performed under near real-time MR guidance, taking advantage of the high tissue contrast, spatial resolution, vascular conspicuity and multiplanar capabilities of MRI to achieve safe and precise needle placement.
The combination of pancreatic parenchyma imaging sequences with secretin-enhanced MRCP and MR angiography offers the possibility of a comprehensive examination within a single diagnostic modality for evaluation of the full range of pancreatic malignancies and in establishing resectability.