Published in:
01-02-2019 | Classics in Abdominal Radiology
The “teardrop sign”
Published in: Abdominal Radiology | Issue 2/2019
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The “teardrop sign” describes the appearance of superior mesenteric vein (SMV) tumor involvement in the setting of pancreatic head adenocarcinoma. It refers to the characteristic teardrop shape, with both a rounded end and a pointed end (Fig. 1). The teardrop shape of the (SMV) reflects tumor tethering the vessel so that on axial images the SMV will change from its normal rounded shape to that of a teardrop (Fig. 2). The sign is predictive of venous involvement, with the inability to dissect the tumor from the SMV [1]. In the absence of the teardrop sign, venous involvement by pancreatic adenocarcinoma generally has been defined by tumor contacting greater than 50% of the vessel circumference [2, 3]
Fig. 1
This large teardrop- or pear-shaped diamond having a rounded end and a more pointed end, similar to the shape of a tethered SMV in pancreatic cancer
Fig. 2
Axial multidetector contrast-enhanced CT (A) illustrating the teardrop appearance of the SMV (white arrow) highly suggestive of venous involvement but with 50% of vessel contact with the pancreatic head adenocarcinoma. Axial multidetector CT in a different patient (B) demonstrates 50% contact of the tumor with SMV with a normal round appearance to the SMV (white arrow) consistent with abutment. Stents are present in the common bile duct and duodenum
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