Final Pr. ID: Poster #: EDU-031
Pancreatic neoplasms are rare in children and young adults, with an incidence of 0.46 per million under 30 years of age. Fortunately, children with a pancreatic neoplasm have a better prognosis than adults. The better prognosis and rarity of disease both contribute to the fact that pancreatic malignancies account for less than 0.2% of cancer-related deaths.
Ultrasound is often the initial imaging modality to identify a pancreatic neoplasm due to its use for evaluation of symptoms such as upper abdominal pain, a palpable epigastric mass, or jaundice. Known pancreatic masses, or those detected initially by ultrasound should be imaged with CT or MRI to best characterize the mass and its relationship to adjacent structures, particularly the vasculature. Nuclear medicine plays a role in imaging of some pancreatic neoplasms depending on histology.
Once a pancreatic neoplasm is identified, the radiologist is tasked with making a diagnosis from a differential diagnosis list of rare tumors. Primary pancreatic neoplasms are divided into epithelial and nonepithelial types. The epithelial tumors are more common and may be further subdivided into exocrine or endocrine subtypes. Epithelial exocrine tumors are the most common in children. Examples of these tumors include the two most common pediatric pancreatic neoplasms pancreatoblastoma and solid-pseudopapillary neoplasms. Endocrine tumors are uncommon. While functioning endocrine tumors can occur, non-functioning tumors are more common and are associated with syndromes such as von Hippel Lindau, multiple endocrine neoplasia type 1, and tuberous sclerosis. Nonepithelial tumors are also rare and include a number of different entities such as lymphoma, neurofibroma, and teratomas. Finally, the pancreas is an extremely rare site of metastasis. Pancreatic metastases can occur with multiple primary malignancies including neuroblastoma, rhabdomyosarcoma, and osteosarcoma.
This exhibit will describe the imaging work-up of pancreatic tumors in children. We will illustrate the different clinical manifestations and imaging appearances of the various pediatric pancreatic neoplasms. Read More
Final Pr. ID: Poster #: EDU-072
Pancreatic tumors are very rare in the pediatric population, with a reported incidence of 1.8 cases per 1,000,000 children in the United States. Several case reviews in the literature from large referral centers have yielded relatively few cases of pancreatic neoplasm. The most commonly reported pancreatic tumors include solid pseudopapillary epithelial neoplasm (SPEN), pancreatoblastoma, and neuroendocrine tumors. Other, more commonly encountered pancreatic abnormalities include trauma and pancreatitis. Given their rarity, the imaging characteristics of pancreatic lesions at MRI may be unfamiliar. The purpose of this exhibit is to present the typical imaging appearance of various pancreatic lesions in children. Read More
Final Pr. ID: Poster #: EDU-035
Accidental traumatic injuries of the pancreas are rare but dangerous. In children, blunt abdominal trauma is the most common mechanism.
The goal of this presentation is to review, through a series of cases, the diagnosis, imaging findings, classification, and management of accidental traumatic pancreatic injuries in children.
Our cases include an 18-year-old football player with traumatic pancreatitis and pseudocyst formation, a 12-year-old pinned between two vehicles who sustained a pancreatic laceration with full transection of the pancreatic duct, a 15-year-old soccer player with a pancreatic laceration and truncated duct on ERCP, and a 5-year-old boy who was run over by a car and developed shock pancreas.
Traumatic injuries, as graded by the guidelines of the American Association for the Surgery of Trauma, span a gamut including contusion, laceration, transection, duct injury, ampulla injury, and massive destruction of the pancreatic head. Complications include fistula, pancreatitis, and the development of pseudocysts. Through multiple imaging modalities - including CT, MR, MRCP, ERCP, and ultrasound – our cases illustrate many of these injuries and subsequent complications.
While nonoperative treatment of minor pancreatic injuries is widely accepted, the management of more severe pancreatic injuries, such as those involving the pancreatic duct, is more controversial. Duct injury, for example, has been reported to be predictive of failure of non-operative management.
The radiologist, therefore, has the opportunity to play a pivotal role in patient care by characterizing the injury. Pancreatic organ and duct injuries can be subtle and correlation with multiple modalities as well as multidisciplinary discussion between the radiologist, surgeon, and gastroenterologist, are often required. Read More
Keywords: Trauma, Pancreas
Final Pr. ID: Poster #: SCI-008
The application of compressed SENSE MR imaging technique can help in reducing the acquisition time for magnetic resonance cholangiopancreatography (MRCP). The present study was conducted to compare the acquisition time, diagnostic efficacy, and image quality of the newer compresses sense 3D-MRCP (CS-3D-MRCP) with conventional 3D MRCP (C-3D-MRCP) in children with pancreatitis. Read More