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MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations.

Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M - Korean J Radiol (2015)

Bottom Line: This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma.MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey.

ABSTRACT
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

No MeSH data available.


Related in: MedlinePlus

Pseudocyst in duodenum wall.On magnetic resonance cholangiopancreatography (MRCP) (A) and axial T2-weighted MR images (B), cystic lesion consistent with pseudocyst is seen at lateral wall of duodenum in patient with chronic pancreatitis (black arrows in A and B). On MRCP image, pancreatic duct is dilated and irregular because of chronic pancreatitis (arrowhead in A). In pancreatitis, depending on depth of penetration, pseudocysts settle either between serosa and muscular layer or between muscular layer and mucosa. With accumulation of secretion and increase of pressure, obstruction in intestinal lumen and gastric outlet syndrome may occur. Tubular shape of pseudocyst that complies with progress of intestinal wall and abrupt flattening on intestine wall are findings that indicate intramural settlement. Duplication cysts and choledochocele should be considered in differential diagnosis.
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Figure 17: Pseudocyst in duodenum wall.On magnetic resonance cholangiopancreatography (MRCP) (A) and axial T2-weighted MR images (B), cystic lesion consistent with pseudocyst is seen at lateral wall of duodenum in patient with chronic pancreatitis (black arrows in A and B). On MRCP image, pancreatic duct is dilated and irregular because of chronic pancreatitis (arrowhead in A). In pancreatitis, depending on depth of penetration, pseudocysts settle either between serosa and muscular layer or between muscular layer and mucosa. With accumulation of secretion and increase of pressure, obstruction in intestinal lumen and gastric outlet syndrome may occur. Tubular shape of pseudocyst that complies with progress of intestinal wall and abrupt flattening on intestine wall are findings that indicate intramural settlement. Duplication cysts and choledochocele should be considered in differential diagnosis.

Mentions: The duodenum wall is a rare place of settlement for pancreatic pseudocysts. However, the inflammation and secretion that spread from the pancreas may cause the creation of pseudocysts on the posterior surface of the duodenum that are not covered by the peritoneum and that directly touch the head of pancreas. Because of this anatomic relationship, pseudocysts are most frequently seen in the 2nd segment (Fig. 17) (3637). A similar compression can be caused by rare diseases such as hydatid cysts (Fig. 18).


MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations.

Dusunceli Atman E, Erden A, Ustuner E, Uzun C, Bektas M - Korean J Radiol (2015)

Pseudocyst in duodenum wall.On magnetic resonance cholangiopancreatography (MRCP) (A) and axial T2-weighted MR images (B), cystic lesion consistent with pseudocyst is seen at lateral wall of duodenum in patient with chronic pancreatitis (black arrows in A and B). On MRCP image, pancreatic duct is dilated and irregular because of chronic pancreatitis (arrowhead in A). In pancreatitis, depending on depth of penetration, pseudocysts settle either between serosa and muscular layer or between muscular layer and mucosa. With accumulation of secretion and increase of pressure, obstruction in intestinal lumen and gastric outlet syndrome may occur. Tubular shape of pseudocyst that complies with progress of intestinal wall and abrupt flattening on intestine wall are findings that indicate intramural settlement. Duplication cysts and choledochocele should be considered in differential diagnosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644744&req=5

Figure 17: Pseudocyst in duodenum wall.On magnetic resonance cholangiopancreatography (MRCP) (A) and axial T2-weighted MR images (B), cystic lesion consistent with pseudocyst is seen at lateral wall of duodenum in patient with chronic pancreatitis (black arrows in A and B). On MRCP image, pancreatic duct is dilated and irregular because of chronic pancreatitis (arrowhead in A). In pancreatitis, depending on depth of penetration, pseudocysts settle either between serosa and muscular layer or between muscular layer and mucosa. With accumulation of secretion and increase of pressure, obstruction in intestinal lumen and gastric outlet syndrome may occur. Tubular shape of pseudocyst that complies with progress of intestinal wall and abrupt flattening on intestine wall are findings that indicate intramural settlement. Duplication cysts and choledochocele should be considered in differential diagnosis.
Mentions: The duodenum wall is a rare place of settlement for pancreatic pseudocysts. However, the inflammation and secretion that spread from the pancreas may cause the creation of pseudocysts on the posterior surface of the duodenum that are not covered by the peritoneum and that directly touch the head of pancreas. Because of this anatomic relationship, pseudocysts are most frequently seen in the 2nd segment (Fig. 17) (3637). A similar compression can be caused by rare diseases such as hydatid cysts (Fig. 18).

Bottom Line: This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma.MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Ankara University School of Medicine, Ankara 06100, Turkey.

ABSTRACT
This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery.

No MeSH data available.


Related in: MedlinePlus