Figure 3.

A 59-year-old woman with a serous cystic tumor. At US (a) a small hypoechoic lesion with no posterior acoustic enhancement is appreciable in the body of the pancreas. The lesion shows ‘honeycomb’ architecture. At CT in the unenhanced phase (b) the lesion appears hypodense with focal bulging of the pancreatic borders. After injection of iodinated contrast agent the lesion appears hypovascular in the arterial (c) and pancreatic (d) phase, showing enhancement of thin septa in the center of the lesion during the distribution phase (e). At MR the lesion is markedly hyperintense on T2 HASTE images, with microscystic appearance (f); in this sequence a branching of the main pancreatic duct in the tail can be observed (arrowheads). On T1w fat sat (g) the lesion appears hypointense with thin central septa which show enhancement after injection of paramagnetic contrast agent (h). MRCP (i) confirms the microcystic appearance; the close relationship between the cystic lesion and the m.p.d. does not allow exclusion of the presence of a communication. However, the microcystic appearance and the normal m.p.d. allow a correct diagnosis of serous cystic tumor.