DFA1 ≥ 1200 U/L is an important predictive factor for PF of any degree. The trend of DFA3 (decrease of < 50%) compared to DFA1 is a significant factor in the differentiation of CRPF from transient BPF.

Pancreatic pseudoaneurysm is a rare but life-threatening clinical entity. In this paper, we present a case of a 74-year-old man, who was admitted to our clinic with a diagnosis of an acute on chronic pancreatitis complicated by walled-off-pancreatic-necrosis, with subsequent development of peripancreatic pseudoaneurysm. After initial conservative management, the patient recovered and was discharged from the hospital. However, he soon returned feeling anxious due to a pulsatile abdominal mass. Abdominal Color–Doppler examination, CT scan, and angiography revealed large pancreatic necrotic collection in the total size of 9 cm, with centrally enhancing area of 3.5 cm that corresponded to pseudoaneurysm originating from the posterior pancreaticoduodenal vascular arcade. Considering the size, location of the pseudoaneurysm, feeding vessel, and poor general patients condition, we opted for minimally invasive treatment. Pseudoaneurysm was successfully managed by endovascular coil embolization, i.e., “sandwich technique”.

Background Pancreatic adenocarcinoma is a highly lethal disease even in initially resectable patients. Functional imaging procedures such as diffusion-weighted imaging (DWI) and computed tomography (CT)-perfusion might facilitate preoperative prediction of factors influencing prognosis in patients with pancreatic adenocarcinoma. Purpose To evaluate CT-perfusion and DWI quantitative parameters of pancreatic adenocarcinoma and to assess their correlation with clinicopathological features. Material and Methods Forty-four patients with histopathologically proven pancreatic adenocarcinoma underwent CT-perfusion and DWI for estimating blood volume (BV), blood perfusion (BF), mean transit time (MTT), time to peak (TTP), and apparent diffusion coefficient (ADC) values. The statistical analysis was performed using Wilcoxon matched-pairs test, t-test for independent samples, Spearman’s rank correlation coefficient (rs), and receiver operating characteristic analysis. Results The mean CT-perfusion parameters and ADCs were significantly different in pancreatic adenocarcinoma versus healthy parenchyma. BV (2.66 ± 0.98 mL/100g), BF (17.45 ± 4.06 mL/min/100g), and ADCs (0.91 ± 0.15 × 10−3mm/s2) in high-grade tumors were significantly lower in comparison to low-grade tumors (BV = 5.35 ± 1.36 mL/100g, BF = 28.51 ± 7.73 mL/min/100g, ADC = 1.07 ± 0.21 × 10−3mm/s2). For prediction of high-grade tumors, the sensitivity and specificity were 79.2% and 82.4% for BF and 87.5% and 88.2% for BV, respectively. A significant negative correlation was found between BV and tumor size (rs = −0.445, P = 0.029), MTT and tumor size (rs = −0.330, P = 0.043), BV and M-stage (rs = −0.286, P = 0.049), and ADC and M-stage (rs = −0.274, P = 0.038). Moreover, BF and BV values were significantly associated with ADCs. Conclusion CT-perfusion parameters and ADC values could improve preoperative assessment of pancreatic adenocarcinoma with possibility of tumor grade prediction.

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy, with mass-forming growth pattern being the most common. The typical imaging appearance of mass-forming ICC (mICC) consists of irregular ring enhancement in the arterial phase followed by the progressive central enhancement on portal venous and delayed phases. However, atypical imaging presentation in the form of hypervascular mICC might also be seen, which can be attributed to distinct pathological characteristics. Ancillary imaging features such as lobular shape, capsular retraction, segmental biliary dilatation, and vascular encasement favor the diagnosis of mICC. Nevertheless, these radiological findings may also be present in certain benign conditions such as focal confluent fibrosis, sclerosing hemangioma, organizing hepatic abscess, or the pseudosolid form of hydatid disease. In addition, a few malignant lesions including primary liver lymphoma, hemangioendothelioma, solitary hypovascular liver metastases, and atypical forms of hepatocellular carcinoma (HCC), such as scirrhous HCC, infiltrative HCC, and poorly differentiated HCC, may also pose a diagnostic dilemma by simulating mICC in imaging studies. Diffusion-weighted imaging and the use of hepatobiliary contrast agents might be helpful for differential diagnosis in certain cases. The aim of this manuscript is to provide a comprehensive overview of mICC imaging features and to describe useful tips for differential diagnosis with its potential mimickers.