MRI technique for pancreatic tumors

Patients should be fasted for at least four hours. Oral water and an anti-peristaltic
agent are given. Optimal technique requires a quadrature phased-array coil. The
following images should be viewed:

•  Axial T1
•  Axial fat-suppressed T1-weighted
•  Axial and coronal fast spin-echo, T2-weighted
•  Axial T2 FatSat
•  Axial dynamic contrast-enhanced gradient echo sequence
•  Axial diffusion-weighted (optional)

The tumours usually appear to be of low signal intensity on T1-weighted sequences
and high signal intensity on T2-weighted sequences in relation to the pancreas. The
tumours are often most conspicuous on the fat-suppressed T1-weighted image
whether spin-echo or gradient-recalled.Tumours that contain high collagen or
fibrous tissue content may return a low signal intensity on T2-weighted images, but
this is rare. Following IV gadolinium administration, there is characteristic marked
homogeneous enhancement, reflecting the highly vascular nature of these tumours.
Enhancement oftens renders the tumour isointense with the surrounding pancreas
on the T1-fat-suppressed sequence. In cystic lesions, rim enhancement may be
seen.

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