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Discrimination of Unilocular Macrocystic Serous Cystadenoma from Pancreatic Pseudocyst and Mucinous Cystadenoma with CT: Initial Observations¹

¹ From the Departments of Radiology (F.C.S., V.V., G.B., M.P.V., Y.M.), Gastroenterology (P.H.), and Hepatobiliary and Digestive Surgery (A.S.), Hôpital Beaujon, Clichy, France. Received August 7, 2002; revision requested October 2; revision received October 27; accepted January 15, 2003. Address correspondence to G.B., Department of Radiology, University of Palermo, Via Villaermosa 29, 90139 Palermo, Italy (e-mail: gbranca@yahoo.com).

View larger version (136K): [in a new window]   Figure 1. Transverse CT scan obtained during the pancreatic phase in a 50-year-old woman with unilocular macrocystic serous cystadenoma. Image shows a cystic lesion (arrow) in the head of the pancreas surrounded by an imperceptible wall. Margins appear lobulated. Note the peripheral calcification (arrowhead).

View larger version (136K): [in a new window]   Figure 2. Transverse CT scan obtained during the pancreatic phase in a 30-year-old man with unilocular macrocystic serous cystadenoma. Image shows a lobulated cystic lesion (arrows) in the head of the pancreas surrounded by an imperceptible wall. The hyperattenuating focus seen in the cyst lumen (arrowhead) represents partial volume averaging of a pancreatic vessel.

View larger version (86K): [in a new window]   Figure 3a. Transverse CT scans obtained in a 40-year-old woman with mucinous cystadenoma. (a) Image obtained without intravenous contrast material demonstrates a round cystic lesion (arrow) in the tail of the pancreas. The lesion wall is thick. (b) Image obtained after the intravenous injection of contrast material reveals enhancement of the wall (long arrow). Note the perigastric collateral vessels (short arrows).

View larger version (93K): [in a new window]   Figure 3b. Transverse CT scans obtained in a 40-year-old woman with mucinous cystadenoma. (a) Image obtained without intravenous contrast material demonstrates a round cystic lesion (arrow) in the tail of the pancreas. The lesion wall is thick. (b) Image obtained after the intravenous injection of contrast material reveals enhancement of the wall (long arrow). Note the perigastric collateral vessels (short arrows).

View larger version (94K): [in a new window]   Figure 4. Transverse CT scan obtained in a 44-year-old woman with mucinous cystadenoma. Image obtained after the intravenous injection of contrast material demonstrates a round cystic lesion (arrows) in the tail of the pancreas. The wall is thick and enhancing on this contrast-enhanced image. Note the septum (arrowhead).

View larger version (131K): [in a new window]   Figure 5. Transverse CT scan obtained in a 44-year-old woman with mucinous cystadenoma. Image obtained after intravenous injection of contrast material reveals an ovoid cystic lesion (black arrow) in the tail of the pancreas. The anterior portion of the wall (white arrows) is thick and enhancing on this contrast-enhanced image.

View larger version (147K): [in a new window]   Figure 6. Transverse CT scan obtained during portal venous phase in a 28-year-old man with pseudocyst. Image demonstrates a pseudocyst (arrow) in the tail of the pancreas surrounded by a thick enhancing wall. The lesion appears heterogeneous with central areas of higher attenuation, which is suggestive of fresh hemorrhage. Note infiltration (arrowheads) of the peripancreatic fat.

View larger version (114K): [in a new window]   Figure 7. Transverse CT scan obtained during portal venous phase in a 55-year-old woman with unilocular macrocystic serous cystadenoma. Image depicts a cystic lesion (arrows) with lobulated margins in the tail of the pancreas surrounded by a thin nonenhancing wall.

View larger version (100K): [in a new window]   Figure 8. Transverse CT scan obtained during portal venous phase in a 60-year-old woman with unilocular macrocystic serous cystadenoma. Image shows a lobulated cystic lesion (arrow) in the tail of the pancreas surrounded by a thin nonenhancing wall. Incidentally, a large hepatic cyst (arrowhead) is seen.

View larger version (103K): [in a new window]   Figure 9. Transverse CT scan obtained during portal venous phase in a 38-year-old woman with unilocular macrocystic serous cystadenoma. Image shows a round cystic lesion (arrow) in the body of the pancreas surrounded by a uniformly imperceptible wall.