Duodenal duplication cyst: MR imaging appearance

Abstract

The MR imaging appearance of a duodenal duplication cyst is reported. MR imaging confirmed the diagnosis suggested by ultrasound and CT scans. Fat-suppressed MR imaging before and after oral administration of the positive contrast agent Gd-DTPA was able to define tissue planes between the lesion and adjacent structures, such as the head of the pancreas, providing useful information for an accurate surgical approach. To our knowledge this is the first reported case of a duodenal duplication cyst in an adult demonstrated by MR imaging.

Meta-analysis: the clinical features of the duodenal duplication cyst

“…Even abdominal ultrasound and CT/MRI can efficiently detect duodenal duplication cysts [36]. However, of the reviewed cases, the false-negative rate is 23% by ultrasound and 9% by CT scan or MRI.…”

Duodenal duplication cyst identified with MRCP

“…In the emptying stage, DD demonstrates a solid structure and the differential diagnosis with either neoplastic or inflammatory duodenal or pancreatic lesions has to be made. Imaging features of DD at upper gastrointestinal series, CT examination, and, more recently MR imaging, have already been described, the latter imaging technique being particularly useful in defining tissue planes between DD and adjacent structures through tailored fat-suppressed sequences [2,3,6]. As a cause of pancreatitis, the diagnosis of DD can be presently achieved also by means of MRCP.…”

“…The intraluminal mass has to be differentiated from either a peduncled neoplastic lesion or an intraluminal duodenal diverticulum. The intramural mass raises even more diagnostic problems, considering its stage (distension or emptying, in the latter a communication with the duodenal lumen being present) [6]. In the distension stage, DD has to be differentiated from other cystic masses belonging to the duodenal-choledochal-pancreatic area (such as cystic dystrophy of the duodenal wall, choledochal cyst, pseudocyst, cystic tumors of the pancreas, cystic lymphangioma, and mesenteric cyst).…”

“…It shows spherical or elongated morphology, and can be responsible for duodenal obstruction, pancreatitis [2,3,4], and, in rare cases, gastrointestinal bleeding [5]. The imaging features of this lesion at CT and MR imaging have already been described [2,3,6]. Daily use of MR cholangiopancreatography (MRCP) in the study of biliary and pancreatic disorders may justify use of this technique in identification of this lesion.…”

Duodenal duplication cyst: beware of the lesser sac collection

“…Contrast enhanced CT provides an accurate definition of the cyst and its relations [2,21]. Magnetic resonance imaging [22] and magnetic resonance cholangiopancreatography [23] have also been utilised.…”