Incidental pancreatic cysts are fluid-filled pockets that develop in or on the pancreas, typically identified on imaging tests done for another purpose. Common pancreatic cysts include intraductal papillary mucinous neoplasms, serous cystadenomas, and mucinous cystic neoplasms.
For incidental pancreatic cysts less than or equal to 2.5 cm in size, MRI abdomen without and with contrast with magnetic resonance cholangiopancreatography (MRCP) (MRI test designed to assess the pancreatic system) is usually appropriate. Multiphase CT abdomen (images taken at different time points) and MRI abdomen without contrast with MRCP may be appropriate.
For incidental cysts greater than 2.5 cm with no additional worrisome features, MRI abdomen without and with contrast with MRCP is usually appropriate. Multiphase CT abdomen with contrast, MRI abdomen without contrast with MRCP, and ultrasound abdomen endoscopic may be appropriate.
For cysts greater than 2.5 cm with worrisome features, abdominal endoscopic ultrasound or MRI abdomen without and with contrast with MRCP is usually appropriate. Multiphase CT abdomen with contrast and MRI abdomen without contrast with MRCP may be appropriate.
If the pancreatic duct (tube for pancreatic juices for digestion) is greater than 7 mm, abdominal endoscopic ultrasound, MRI abdomen without and with contrast with MRCP, and MRI abdomen without contrast with MRCP are usually appropriate. Multiphase CT abdomen with contrast may be appropriate.
Multiphase CT abdomen with contrast, MRI abdomen without and with contrast with MRCP, and MRI abdomen without contrast with MRCP are usually appropriate for follow-up imaging.