US and CT imaging features of intrapancreatic metastases.

Objective: Twenty-four patients with intrapancreatic metastases were retrospectively studied to identify diagnostic criteria on cross-sectional imaging.

Materials And Methods: Ultrasound and CT of the pancreas were reexamined by two radiologists who specified morphologic patterns.

Results: Metastases of the pancreas were found more often solitary (14 cases) than multiple (10 cases) and as homogeneous nodules hypoechoic on US (15 cases), hypodense on CT (11 cases), sometimes hypervascular (6 cases) or pseudocystic (4 cases). Dynamic contrast-enhanced CT demonstrated small lesions 10 mm in diameter (three cases), not seen on US, and was highly suggestive when it showed several nodules in the gland. We identified some other criteria of intrapancreatic metastatic disease: two or more locations in the pancreas, nonobliteration of the retropancreatic fat regardless of the size of the lesion, nondilated biliary tree in the case of a large tumor of the pancreatic head, and a hypervascular mass without endocrine syndrome. Percutaneous puncture assessed the diagnosis (10 cases) and differentiated metastases from a primary ductal adenocarcinoma of the pancreas.

Conclusion: Detection and identification of suggestive features of pancreatic metastases may be obtained by examination of the pancreas with dynamic CT.