Radiologic diagnosis of pancreatic carcinoma.

Radiological diagnostic techniques for the evaluation of pancreatic duct cell adenocarcinoma and their findings are discussed. Pancreatic carcinoma may demonstrate one or more of these diagnostic signs: focal enlargement or deformity, density changes, obliteration and dilatation of the pancreatic and/or biliary duct, local invasion, and metastases. Ultrasonography is commonly used as a screening examination. The presence of pancreatic carcinoma may best be evaluated by dynamic computed tomography (CT) or dynamic magnetic resonance (MR) imaging with administration of intravenous contrast material. Both CT and MR imaging are used for the preoperative assessment of local invasion and vascular involvement. MR cholangiopancreatography (MRCP) allows noninvasive three-dimensional delineation of the pancreatic and biliary duct systems. Angiography may demonstrate vascular involvement questionable on noninvasive examinations. In the near future, the value and efficacy of MR imaging in the diagnosis of small pancreatic carcinoma need to be assessed in comparison with CT and endoscopic studies.