The arterial phase of enhancement, which corresponds to the first 30 seconds after the start of the contrast injection, provides excellent opacification of the celiac axis, superior mesenteric artery, and peripancreatic arteries. The portal venous phase, which is obtained at 60 to 70 seconds after the start of the contrast

injection, provides better enhancement of the superior mesenteric vein, splenic and portal veins as well as the pancreas itself and any liver metastases that may be present. Even though pancreatic protocol CT is widely regarded to be superior to non-pancreatic protocol contrast MDCT for determining Inhibitors,research,lifescience,medical resectability, there is currently insufficient direct evidence to support this. Magnetic Resonance Imaging (MRI) and Magnetic

Resonance Cholangiopancreatography (MRCP) Magnetic resonance imaging (MRI) can be used in imaging for PaCa in patients with equivocal findings at ultrasound or MDCT. MRI examination of the pancreas is done with intravenous administration of contrast material and gadolinium is the most commonly Inhibitors,research,lifescience,medical used agent. PaCa is hypointense on gadolinium-enhanced T1-weighted images in the pancreatic and venous phases because it is hypovascular with abundant find more fibrous stroma compared to the pancreatic parenchyma. Tumors appear isointense on delayed images because of slow wash-in of contrast Inhibitors,research,lifescience,medical medium. MRI is commonly used to detect PaCa when a mass lesion is not identifiable on CT scan. There is however no significant diagnostic advantage of MRI over contrast- enhanced CT (sensitivity of 86% on CT vs. 84% on MRI) (24). Combining the two tests does not improve upon what is achieved with one test alone. MRI is better Inhibitors,research,lifescience,medical at characterizing cystic lesions of the pancreas and can provide some indirect radiological evidence to aid in diagnosis of pancreatic cancer. The choice of MRI or CT usually depends upon available local expertise and the clinician’s comfort with one or the other radio-imaging technique. Inhibitors,research,lifescience,medical It is contraindicated in patients with metal in the body (e.g.: pacemakers, implants) and contrast allergy. Magnetic

resonance cholangiopancreatography (MRCP) is a useful adjunct to other radiographic diagnostic techniques and may emerge as the preoperative imaging procedure of choice for patients with suspected PaCa. MRCP uses magnetic resonance technology to create a three Electron transport chain dimensional image of the pancreaticobiliary tree, liver parenchyma, and vascular structures. MRCP is better than CT for defining the anatomy of the biliary tree and pancreatic duct, has the capability to evaluate the bile ducts both above and below a stricture, and can also identify intrahepatic mass lesions. It is reportedly as sensitive as ERCP in detecting pancreatic cancers and unlike conventional ERCP, does not require contrast material to be administered into the ductal system (25).