Duct penetrating sign (pancreas)

Duct penetrating sign is a radiographic sign that can be useful in differentiating between focal pancreatitis (inflammatory pancreatic mass) from pancreatic carcinoma.

A positive sign is when a mass is penetrated by an unobstructed pancreatic duct; this makes focal pancreatitis the most likely cause rather than pancreatic carcinoma. This sign is best appreciated on MRCP (or ERCP).

The duct-penetrating sign on MRCP is more helpful in differentiating between these two entities than a delayed enhancement pattern on CT or MRI.