PMC6180859_01
Axial unenhanced CT scan showing soft tissue density lesion (black arrow with white outline) with a cystic lesion within the lesion in the pancreaticoduodenal groove with poorly defined fat planes with adjacent duodenum (white arrow) and pancreas.
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fig1
On unenhanced CT image, a poorly defined soft tissue mass was seen in the pancreaticoduodenal (PD) groove with a hypodense cystic lesion within the mass (Figure 1).
Axial contrast-enhanced CT image (portal venous phase) showing a minimally enhancing lesion with cystic change within (black arrow with white outline) the pancreaticoduodenal groove with adjacent duodenum showing wall thickening (white arrow with black outline) and poorly defined fat plane with pancreatic head and uncinate process (black arrowhead). Incidentally, few simple cortical cysts were also noted in both kidneys.
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fig2
On post-contrast study, the lesion showed minimal enhancement in the portal venous phase (Figures 2 and 3), but delayed imaging at 2-3 min showed mild persistent enhancement of the lesion compared with the pancreatic parenchyma that was consistent with scar tissue (Figure 4) and a non-enhancing cystic lesion within the lesion.
Axial contrast-enhanced CT image (portal venous phase) showing a soft tissue density lesion (white arrow) in the pancreaticoduodenal groove that merges imperceptibly with the head of the pancreas, but the rest of the pancreatic body and tail (black arrow) shows normal appearance with no evidence of duct dilatation.
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fig3
On post-contrast study, the lesion showed minimal enhancement in the portal venous phase (Figures 2 and 3), but delayed imaging at 2-3 min showed mild persistent enhancement of the lesion compared with the pancreatic parenchyma that was consistent with scar tissue (Figure 4) and a non-enhancing cystic lesion within the lesion.
Axial contrast-enhanced CT image showing persistent mild enhancement of the lesion consistent with fibrous scar tissue in delayed phase imaging (arrow).
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fig4
On post-contrast study, the lesion showed minimal enhancement in the portal venous phase (Figures 2 and 3), but delayed imaging at 2-3 min showed mild persistent enhancement of the lesion compared with the pancreatic parenchyma that was consistent with scar tissue (Figure 4) and a non-enhancing cystic lesion within the lesion.
(a, b) Axial two-dimensional fast imaging employing steady-state acquisition fat-saturated images showing a soft tissue intensity lesion with cystic change within in the pancreaticoduodenal groove that merges imperceptibly with the head of the pancreas (black arrow with white outline) and poorly defined fat plane with adjacent duodenum (white arrow).
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fig5
Axial two-dimensional fast imaging employing steady-state acquisition (Figure 5a,b) sequences showed soft tissue signal intensity lesion in the PD groove with a cystic lesion within the lesion and the aforementioned CT scan findings.
(a) Coronal reformatted MR cholangiopancreatographic image showing normal common bile duct calibre (black arrow with white outline). (b) Coronal reformatted MR cholangiopancreatographic image showing a cystic lesion within the soft tissue intensity lesion (white arrow with black outline) and adjacent smooth and regular tapering of the pancreatic and common bile ducts (black arrow).
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fig6
MR cholangiopancreatography sequence (Figure 6a,b) revealed smooth and regular tapering of the pancreatic and common bile ducts.