Boraschi P, Cervelli R, Donati F. Common cystic pancreatic neoplasms: A comprehensive magnetic resonance imaging-based review of typical and atypical imaging features. World J Radiol 2026; 18(7): 120526 [DOI: 10.4329/wjr.120526]
Corresponding Author of This Article
Piero Boraschi, MD, Chief, Department of Diagnostic Imaging, Azienda Tutela Della Salute (ATS) Liguria, Area Sociosanitaria Locale 5, Via Vittorio Veneto 197, La Spezia 19121, Liguria, Italy. p.boraschi@gmail.com
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Radiology, Nuclear Medicine & Medical Imaging
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review-article
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Boraschi P, Cervelli R, Donati F. Common cystic pancreatic neoplasms: A comprehensive magnetic resonance imaging-based review of typical and atypical imaging features. World J Radiol 2026; 18(7): 120526 [DOI: 10.4329/wjr.120526]
World J Radiol. Jul 28, 2026; 18(7): 120526 Published online Jul 28, 2026. doi: 10.4329/wjr.120526
Common cystic pancreatic neoplasms: A comprehensive magnetic resonance imaging-based review of typical and atypical imaging features
Piero Boraschi, Rosa Cervelli, Francescamaria Donati
Piero Boraschi, Department of Diagnostic Imaging, Azienda Tutela Della Salute (ATS) Liguria, La Spezia 19121, Liguria, Italy
Rosa Cervelli, Francescamaria Donati, Department of Radiological Nuclear and Laboratory Medicine, Pisa University Hospital, Pisa 56124, Tuscany, Italy
Author contributions: Boraschi P conceived and designed the review; Cervelli R and Donati F critically revised the manuscript for important intellectual content; Boraschi P, Cervelli R, and Donati F conducted the literature search, data analysis, and interpretation, drafted the manuscript; all authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work, ensuring the integrity and accuracy of the study.
AI contribution statement: Only limited language-editing assistance may have been used during manuscript revision to improve English readability and grammar. The manuscript was written, critically revised, and scientifically validated entirely by the authors. No scientific content or interpretation was generated by AI tools.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this manuscript.
Corresponding author: Piero Boraschi, MD, Chief, Department of Diagnostic Imaging, Azienda Tutela Della Salute (ATS) Liguria, Area Sociosanitaria Locale 5, Via Vittorio Veneto 197, La Spezia 19121, Liguria, Italy. p.boraschi@gmail.com
Received: March 1, 2026 Revised: March 21, 2026 Accepted: May 22, 2026 Published online: July 28, 2026 Processing time: 144 Days and 23.7 Hours
Abstract
Pancreatic cystic neoplasms are being identified with increasing frequency, largely because high-resolution cross-sectional imaging is now routinely performed in a wide variety of clinical settings. Among available imaging techniques, magnetic resonance imaging (MRI), especially when combined with magnetic resonance cholangiopancreatography, plays a central role in lesion characterization thanks to its excellent soft-tissue contrast and detailed evaluation of the pancreatic ductal system. The most common pancreatic cystic neoplasms include intraductal papillary mucinous neoplasms, serous cystic neoplasms, mucinous cystic neoplasms, and solid pseudopapillary neoplasms, which together account for the majority of cystic pancreatic tumors. Many of these lesions are detected incidentally during imaging examinations performed for unrelated indications, creating an increasingly common diagnostic challenge in routine radiological practice. This review summarizes both typical and atypical MRI findings of the most common cystic pancreatic neoplasms, with particular attention to imaging features that may support differential diagnosis and influence clinical management. In particular, MRI and magnetic resonance cholangiopancreatography are essential for evaluating lesion morphology, intracystic components, and communication with the pancreatic ductal system, all of which are important for lesion characterization and risk stratification. Familiarity with the broad spectrum of MRI appearances is crucial for radiologists in order to improve diagnostic accuracy, recognize atypical presentations, and guide appropriate patient management.
Core Tip: Magnetic resonance imaging combined with magnetic resonance cholangiopancreatography plays a pivotal role in the evaluation of cystic pancreatic neoplasms. Familiarity with both typical and atypical imaging features of intraductal papillary mucinous neoplasms, serous cystic neoplasms, mucinous cystic neoplasms, and solid pseudopapillary tumors improves lesion characterization, supports accurate differential diagnosis, and guides appropriate risk stratification and clinical management, particularly in incidentally detected lesions.
