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OBJECTIVE. The purpose of this study was to describe the typical CT and chemical shift MRI findings and to evaluate their usefulness in the diagnosis of focal fatty replacement of the pancreas in five patients.

CONCLUSION. The presence of a perceptible focal low-attenuation lesion in the pancreas on CT and the reduction in signal intensity of the lesion on the opposed phase of chemical shift MR images are useful for differentiating focal fatty replacement of the pancreas from true pancreatic neoplasm. Therefore, these imaging findings obviate invasive diagnostic procedures and surgery in the care of patients with focal fatty replacement of the pancreas.