Recent Advances in Pancreatic MR Imaging: A Guide on How, When, and Why to Perform

Abstract

Imaging of the pancreas is often challenging because of its retroperitoneal location and unique set of pathologies. Conventional imaging modalities, such as transabdominal and endoscopic ultrasonography (EUS), computed tomography (CT), and magnetic resonance imaging (MRI), are well described in the literature. However, with modern demand for functional and molecular information from imaging studies, newer imaging modalities and modifications of existing modalities are developed. MRI is widely used as a problem-solving tool in pancreatic pathologies. Magnetic resonance cholangiopancreatography (MRCP) is an excellent technique for the depiction of the pancreatic ductal or biliary ductal pathologies. Newer modification of MRI including secretin MRCP, advanced diffusion-weighted imaging (DWI), perfusion imaging, and tissue composition analysis (fat and fibrosis quantification) add to the arsenal of MRI of the pancreas. In this review, we discuss the evolution of MRI of the pancreas and clinical application of advanced MR sequences.

Magnetic Resonance Imaging and Magnetic Resonance Imaging Cholangiopancreatography of the Pancreas in Small Animals

“…The most important reason for this change is the opportunity to acquire a nearly isotropic 3D sequence; however, these sequences are highly sensitive to motion artifacts and may result in poor performance, especially without a breath-holding technique. Another reason for acquiring a 3D sequence instead of 2D is the novel application of this kind of sequence in contrast-enhanced MR angiography (MRA); it can be performed either with or without fat saturation pre-pulse, and it takes advantage of its capability to provide T1w images with thin slices [ 1 , 25 , 26 , 27 , 28 , 29 ]. Last but of course not least, this sequence is T1w and allows acquiring a nearly isotropic 3D T1w GRE sequence pre- and post-contrast administration.…”

“…It allows to dynamically characterize the vascular behaviour of a focal lesion, and for this reason, it can play a role in the investigation of focal hypervascular hepatic lesions. Regarding pancreatic diseases, TWIST-VIBE can help in the identification of small hypervascular (in the arterial phase) lesions, for example, small neuroendocrine tumours such as insulinoma [ 25 , 26 , 27 , 28 , 29 ]. Further studies in small animals are necessary to estimate the potential and the clinical application of this new technique in the evaluation of hepatic and pancreatic disease (e.g., pancreatic insulinoma) [ 26 , 27 , 28 , 29 ].…”