Visualization of the fat planes between the pancreas and the adjacent organs and blood vessels using multi-detector computed tomography

Abstract

Purpose: To explore individual variations in visibility of the fat planes between the pancreatic parenchyma and adjacent organs and blood vessels using the multi-detector-computed tomography (MDCT).

Methods: Abdominal contrast-enhanced MDCT examinations of 520 consecutive adult individuals were retrospectively analysed by exploring the presence of visible fat planes between the healthy pancreas and the following surrounding structures: stomach, descending duodenum (D2), splenic, portal, superior mesenteric vein (SV, PV, SMV), inferior vena cava (IVC), and coeliac trunk, common hepatic and superior mesenteric artery (CT, HA and SMA). Spearman's rank correlation coefficient (r_S) was used to assess the correlation of individual gender, age, body mass and BMI, and visible fat planes towards particular surrounding structures.

Results: Fat planes between the pancreatic parenchyma and surrounding structures was visible as follows: stomach in 76%, D2 11.7%, SV 51.5%, PV 0%, SMV 28.8%, IVC 80.8%, CT 99.4%, HA 90.4% and SMA in 100% participants. The presence of visible fat planes significantly correlated (p < 0.001) with body mass for stomach (r_S = 0.367), D2 (r_S = 0.247), SV (r_S = 0.355), SMV (r_S = 0.384) and IVC (r_S = 0.259); BMI for stomach (r_S = 0.292), SV (r_S = 0.248), SMV (r_S = 0.290) and IVC (r_S = 0.216); age for D2 (r_S = 0.363), SV (r_S = 0.276) and SMV (r_S = 0.409); and male gender for stomach (r_S = 0.160) and SV (r_S = 0.198).

Conclusion: Fat planes around the pancreatic parenchyma in the MDCT scan was almost always visible towards the adjacent magistral visceral arteries and IVC, always invisible towards the PV, and variably visible towards the SV, SMV, stomach and duodenum depending on the individual body mass, BMI, age and gender.

Keywords: Anatomy; Cross-sectional imaging; Fat planes; Multi-detector computed tomography; Pancreas.