الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Pancreatic cancer is a leading cause of death as most cases are unresectable at the time of diagnosis. Early detection promises a better prognosis.
Magnetic resonance imaging is a powerful imaging technique for evaluating pancreatic neoplasms. Improvements in MR pulse sequences, MRCP and MRA have resulted in a highly reliable means of detecting and staging pancreatic neoplasms and distinguishing malignant from benign pancreatic disease processes.
Emerging techniques such as DWI may help to improve the diagnostic capability of magnetic resonance imaging of the pancreas.
This study aimed to determine the usefulness of DWI in detection and characterizing pancreatic pathology whether it is benign or malignant using ADC measurement.
In our DWI study, b values were 0, 500 and 1000 s/mm2, with the application of parallel imaging as well as breath triggering technique, a satisfying image quality has been achievable on a 1.5-T scanner within an acceptable acquisition time.
DWI can be used as an accurate method for detection of pancreas cancer. If positive, a complementary comprehensive study (MRI or MDCT) will probably be needed for staging. If negative, then pancreatic cancer is excluded (NPV of 100 %) and the forthcoming investigations can be more focused on other entities presenting with similar symptoms. Both the examination and the reading time are much shorter for DWI compared with comprehensive MRI, which further speaks in favor of DWI.
This study included 30 patients with suspected pancreatic lesion. The majority of patients presented with obstructive jaundice. All patients underwent dedicated pancreatic MRI examination. The most common site for involvement was pancreatic head, 22 patients had solid lesions ,8 patients had cystic lesions (four patients had mixed solid & cystic components and were considered also as complex cystic lesions).
4 patients had distant metastases, 16 patients had biliary obstruction, 17 had vascular encasement, and 1 showed infiltration of surrounding structures i.e. left kidney, 10 associated with L.N enlargement.
The lesions were also classified into two groups according to possible surgical respectability, based on associated MR imaging findings:
Resectable lesions: which included 9 /30 patients who had clear fat planes around SMV & SMA, Borderline resectable/Unresectable lesions: which included 21/30 patients. They were 4/21 patients who had distant (bone/liver) metastasis, 1/21 patients who had pancreatic mass lesion infiltrating the left kidney, and 16/21 patients in whom MRI showed vascular (Mainly SMA/Celiac trunk) abutment or encasement > 180º.
The addition of DW MR imaging to conventional MR sequences was helpful in increasing the sensitivity of MR imaging for the detection of small pancreatic adenocarcinoma.