Liver metastases from pancreatic adenocarcinoma: MR imaging characteristics

Abstract

Purpose: To describe the magnetic resonance imaging spectrum of appearances of liver metastases from pancreatic ductal adenocarcinoma. Materials and Methods:We retrospectively evaluated the MRI exams performed between July 1996 and August 2001 in all patients who had liver metastases from pancreatic adenocarcinoma and histopathologic diagnosis from either the primary pancreatic tumor, liver metastases, or both. Sixteen patients were included in the study. All MR studies were performed at 1.5 T with a standard protocol including T1-and T2-weighted images and serial post-gadolinium spoiled gradient echo (SGE) images. Location, size, number, signal characteristics on T1-and T2-weighted images, and pattern of enhancement on serial gadolinium-enhanced SGE images were assessed. Results:The diameter of metastases ranged from a few millimetres to 4 cm, and 12 patients (75%) had only lesions of 1.5 cm or less. Capsular-based liver metastases were found in 13 patients (81%) and three patients had only capsular-based lesions with a diameter under 1.5 cm. Hypervascular lesions were found in six patients (38%) and hypovascular lesions in 10 patients (62%). Perilesional enhancement was present in 10 patients (62%), with six patients (38%) having ring perilesional enhancement and eight patients (50%) having wedge-shaped perilesional enhancement. Conclusion:On MR imaging, hepatic metastases from pancreatic adenocarcinoma show a range of enhancement patterns. Hypervascular metastases are not rare. Capsular based distribution, small diameter, and perilesional enhancement are common features. This retrospective study describes the MR imaging spectrum of appearances of liver metastases from pancreatic adenocarcinoma in patients with histopathologic confirmation of the diagnosis.

Magnetic Resonance Imaging of Adenocarcinoma of the Pancreas

“…On immediate postcontrast GE images, they usually demonstrate irregular rim enhancement. 29 Wedge-shaped perilesional enhancement that represents inflammation and neovascularization is also shown on immediate postcontrast images (Figs. 8,9).…”

“…10). 29 We believe that parasitization of hepatic capsular vessels must account for this hypervascular appearance.…”

“…8,9). 29 For small metastatic lesions, homogeneous early enhancement with rapid fading is commonly seen in a subcapsular location. These small subcapsular hypervascular metastases are observed in more than 80% of patients with pancreatic cancer liver metastases and may be the sole manifestation of liver metastases in up to 20% of patients (Fig.…”

Antagonistic Effects of Anti-EMMPRIN Antibody When Combined with Chemotherapy Against Hypovascular Pancreatic Cancers

“…This may be the determining factor of whether addition of anti-EMMPRIN antibody to a given chemotherapeutic regimen will improve clinical outcome. About 85 % of primary pancreatic tumors and 60 % of liver metastases are known to be hypovascular [26, 27]. Fig.…”

Hepatic alveolar echinococcosis: a diagnostic challenge

“…On MRI it is seen as a hypointense mass on T1-weighted images and as a hyperintense mass lesions are hypovascular, they show a diminished late enhancement on contrast-enhanced dynamic imaging (12,13).…”