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Magnetic Resonance Imaging Spectrum of Solid Pseudopapillary Neoplasm of the Pancreas

Objective To describe the magnetic resonance imaging spectrum of solid pseudopapillary tumors (SPTs), with an emphasis on solid SPTs. Methods Thirty-two patients with proven SPTs with preoperative magnetic resonance were included. The SPTs were classified into 3 types: solid, cystic, and mixed; and 2 radiologists analyzed the images regarding the morphologic features and enhancement pattern. Results Of 11 solid SPTs, 9 SPTs (81.8%) were less than 3 cm. Alternatively, of the 18 mixed SPTs and 3 cystic SPTs, 15 SPTs (71.4%) were larger than 3 cm. The predominant imaging features were homogeneous hypoenhancement with a gradually incremental enhancement pattern showing a sharp margin without hemorrhage, whereas those of the mixed SPTs were heterogeneous enhancement showing a sharp margin with internal hemorrhage. Conclusion Solid SPTs frequently present as small, well-defined tumors with a gradual enhancement and without hemorrhage or necrosis, and with features that differ from those of mixed or cystic SPTs.