Pancreas on mri?

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Hi there! I've been posting on some other threads here as well in search for an answer for my constant upper left abdominal pain, left rib pain and back pain. I went for a private MRI (which included mrcp) in August because my dr wouln't refer me. They found gallstones and said the pancreas looked ok. I was wondering though: is MRI suitable for detecting pancreatic problems? I've been searching, and the only thing I find is that drs usually order an ultrasound or CT scan, and MRI is only used to locate bad stuff. But wouldn't any bad stuff show up on MRI in the first place? Hope someone can shed some light. Thanks!

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  • Edited

    Did you have MRI with or without contrast? As far as I remember MRCP is done without contrast.

    MRI in general is quite good at finding pancreatic masses if it is done with contrast. As far as I know it is comparable to a CT scan. CT scan most of the time is preferred but the main reason is that it is cheaper to do so, the scan is much quicker (5-10 min instead of 30-45) and the patients also does not need to hold breath that much for it which is very crucial for the MRI. And most of the people that are scanned are 60+ years old, so holding breath for 20-30 seconds is not evident and it can distort the images taken by the MRI and can introduce "motion artifact".

    To be honest doctors tell me that ultrasound is also pretty good for the pancreas. The problem with it, that if you are a bit obese, then the ultrasound waves cannot really go through fat, making it very difficult to see your pancreas that is why in general ultrasound is not the best tool. Also, it is heavily radiologist specific, it is not like an MRI where you get pictures and can send it to whoever you want, ultrasound is only seen by the radiologist who is doing it. But if you have "lucky" body structure and you are not obese, then seeing the pancreas head is very-very easy and that is where 70-80% of the tumors grow (seeing body-tail, wirsung is also possible). My doctor once told me that he saw a 8-10 mm mass in a lady and referred her to CT scan, but nothing was seen in the CT scan. 1 month later he still saw the mass, referred again and the repeated CT scan missed again. Half year later the mass was 2.5 cm, and then the CT also picked it up too. So yeah, there is definitely a luck component in it. I guess picking up every small thing from any scan is very difficult for all doctors, so it also matters with what kind of symptoms are you present and then they are more likely to look for things that can cause those symptoms.

    • Posted

      Thanks for your reply. The mri was without contrast. I recently also had an ultrasound where I specifically asked them to look at the pancreas. Also nothing. I'd really love to trust the results and let the fears go, because the stress is killing me.

  • Edited

    Hi Nicola, Im having similar symptoms to you and wondering how you are getting on? Since the end of December I've had nausea, burping, discomfort under left rib, and some vomiting and diarrhoea. I'm very scared about it being pancreatic cancer. I've only had an ultrasound to view the pancreas so far.

    In regards to the scans, ive done a lot of reading on which is best for finding pancreatic tumours. In a study i read, CT has a sensitivity of 81%, MRI 89%, and EUS 96%. So MRI is good for finding something. I'm trying to get in for an MRI too because I have had a CT scan in the past so they don't want me to have another due to the radiation.

    • Posted

      Hi! I deeply sympathise. I've been through all the tests and the drs found nothing. I went to see a dietician and felt a lot better after a month or so. The pain has now almost fully subsided. Tbh the anxiety part and going through all the tests is so bad, and I feel so much better now mentally. Go for all the tests you need. And when they say they can't find anything, try to trust in that diagnosis. Hope the MRI turns out okay!

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