pancreas

5. 500 mL neutral oral contrast(water)
100 mL IV contrast (300 mg iodine/mL) at 4
mL/s
Pancreatic phase acquisition of upper abdomen
(at 35-40 s from start of injection or 25 s delay
after trigger)
Portal venous phase (Abdomen and pelvis)
(60-70 s from start of injection or 15-20 s delay
after first scan)

8. • Head and
uncinate
process: 2/3 of
cases
• detected early
stage because of
biliary
• Body and tail:
1/3 of cases
• large at
presentation with
areas of
hemorrhage and
necrosis.

18. Even if 360° contact SMV,
PV cannot be taken as
unresectable.
Vein can be
reconstructed.
So it is Resectable.

22. Important prognostic factor for
early recurrence and metastatic
disease.
On CT it is detected as
infiltrating soft tissue from the
edge of the tumor

29. Insulinomas:
• MC functioning
tumors
Characteristic
Whipple's triad with
low blood glucose.
• >90% lesions are
<2 cm
• Evenly distributed
through head, body
and tail region.
• Multiple lesions in
MEN 1 syndrome
• mostly benign.
Gastrinomas
• Second mc
• Most often seen in
gastrinoma triangle
• mc in head
• avg size 3-4cm
• ZES constitutes a
triad of gastrinoma,
increased gastric
acid production and
peptic ulcers in
unusual locations
• mostly malignant.
Glucagonomas
• Third mc pNET
• Mostly in
pancreatic body
and tail region.
• avg size 5-6cm.
• Present with 4D
syndrome-
dermatitis, dvt,
diabetes and
depression.
• mostly malignant.
VIPomas:
• Rare tumors
• pancreatic or
extrapancreat
ic in origin
• Mostly seen in
tail region.
• avg size 5cm
• WDHA
syndrome-
watery
diarrhea,
hypokalemia,
achlorhydria
• mostly
malignant
Somatostatino
ma
• Rare tumors
• Can present
with diabetes
mellitus,
diarrhea,
steatorrhea,
weight loss