Low density abnormalities of the pancreas on CT are commonly identified. The diagnosis can sometimes not be made on CT alone. MRI of the abdomen is often recommended because it allows these lesions to be better seen and diagnosed. Low density means that the abnormal spot is darker than the pancreas in which it is located. Often these low density abnormalities of the pancreas or spots are small. It is often impossible to say what they are for sure just from the CT in some cases.
It is common to have fat interspersed in the pancreas. It is most common with aging and obesity. Fat is darker than the pancreas on CT. Fat accumulation in the pancreas can look like a low density abnormality on CT. It may not always be clear that the low density spot is fat. In these cases, MRI will be suggested. The diagnosis is usually made on MRI of fat accumulation.
Small low density abnormalities of the pancreas on CT can also represent cystic lesions. Some of these cystic lesions can be precancerous or cancerous. Therefore, an MRI will be ordered for both small and large cysts. The MRI offers the best look on imaging at these cysts. Certain features of the cysts like tumor nodules can make the cyst more suspicious for cancer. A biopsy may be needed for diagnosis.
Low density abnormality of the pancreas can also represent cancer. Pancreatic adenocarcinoma has one of the worst prognosis. Catching it early offers the best chance for survival. Pancreatic cancer will often be low density and ill defined. That means it’s borders are fuzzy. Often the pancreas next to the tumor may be shrunken and the duct which delivers pancreatic enzymes will be dilated or big. But these features may be absent early on. An MRI will offer the best non invasive look at the low density abnormality on CT. A biopsy may than be indicated.
Low density abnormality of the pancreas on CT can therefore range from the benign all the way to cancer. That is why it’s so important to make the diagnosis early. Abdominal MRI will often allow the best non invasive look at a pancreatic abnormality. If the diagnosis is still in question, a specially trained interventional gastroenterologist can biopsy the abnormality.