Elisabetta Raitano, Roberto Cannella, Domenico Messana, Francesco Matteini & Giuseppe Brancatelli
Pancreatic fat deposition is frequently evaluated in imaging of pancreatic diseases. This condition can be linked to a broad range of diffuse diseases and focal pancreatic lesions. Abnormal pancreatic and peripancreatic fat is observed in many pathologic conditions, including obesity, diabetes mellitus, cystic fibrosis, acute and chronic pancreatitis, pancreatic lipoma, and teratoma. Pancreatic fat deposition has also been reported to be a risk factor for pancreatic ductal adenocarcinoma and postoperative pancreatic fistula. Pancreatic fat deposition can cause anatomical changes and abnormal secretion function, leading to insulin resistance and high blood glucose levels. The assessment of pancreatic fat deposition can be performed with ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI). MRI is the most accurate method for the quantification of fat using the proton-density fat fraction (PDFF). The aim of this article is to describe the pathological conditions associated with abnormal pancreatic fat. Knowledge of pancreatic fat distribution can help the radiologists in the differential diagnosis of pancreatic diseases.