Figure 5

Cystic pancreatic lesions with development of solid ITPN in the pancreatic body. (A,B) Initial MRI study with cystic pancreatic lesions. (A) Axial T2 weighted image shows small cystic lesions (arrows) in the pancreatic tail without dilatation of the main pancreatic duct, suggesting small branch duct IPMNs. (B) Axial T1 weighted image after contrast medium administration in the portal venous phase. Tiny cystic lesion without contrast enhancement (arrow). No evidence of the tumor in the pancreatic body. (C–F) Follow-up of the same patient in 7 years. (C) Axial T2 weighted image, known cystic lesions in the pancreatic tail significantly increased in size (arrow). (D) Axial T1 weighted image after contrast medium administration in the portal venous phase. New lesion in the pancreatic body showing solid pattern of contrast enhancement being almost isointense to pancreatic parenchyma. (E) Axial T2 weighted image, elongated solid lesion within the pancreatic body (dotted arrows), which was histologically confirmed as ITPN after resection. (F) DWI with b-value 800 s/mm² with restricted diffusion within the lesion.