MU Digital Repository
Logo

Intraductal papillary mucinous neoplasm of pancreas: Multi-Detector Row CT with 2D curved reformations correlation with MRCP1

Rajagopal, KV (2006) Intraductal papillary mucinous neoplasm of pancreas: Multi-Detector Row CT with 2D curved reformations correlation with MRCP1. Radiology, 238 (2). pp. 560-569.

[img] PDF
14.pdf - Published Version
Restricted to Registered users only

Download (481kB) | Request a copy

Abstract

Purpose: To retrospectively compare accuracy of multi– detector row computed tomography (CT), combined with two-dimensional (2D) curved reformations, and that of magnetic resonance (MR) cholangiopancreatography (MRCP) for characterization of intraductal papillary mucinous neoplasm (IPMN) as malignant, with pathologic examination as reference standard. Materials and Methods: Institutional review board approval was obtained, informed consent was waived, and study was HIPAA compliant. Twenty-five patients (12 women, 13 men; age range, 44–88 years) with pathologically proved IPMN were examined with dual-phase CT with 1.25-mm-thick sections for pancreatic phase; 2D curved reformations along main pancreatic duct (MPD) were generated. T2-weighted MRCP included thick- and thin-slab single-shot fast spinecho imaging and transverse fast spin-echo imaging. Two radiologists, blinded to surgical and pathologic findings, evaluated images for lesion location, septa, mural nodules, communication with MPD, extent and diameter of MPD dilatation, calcifications, and vascular encasement. Malignancy was suspected when one of the following was present: MPD diameter larger than 10 mm, mural nodules, vascular encasement, peripancreatic lymphadenopathy, or metastases. Sensitivity and specificity values for prediction of malignancy were calculated for CT and MRCP. Interobserver variability was determined (� analysis). Results: Excellent correlation between modalities was observed. Cyst communication was seen in 20 and 21 of 24 branch pancreatic duct (BPD) IPMNs with CT and MRCP, respectively. Sensitivity, specificity, and accuracy for detection of malignancy were 70%, 87%, and 76% (CT) and 70%, 92%, and 80% (MRCP), respectively. Interobserver agreement was good to perfect for both readers in all comparisons (overall, � � 0.70–1.00). Conclusion: CT combined with 2D curved reformation can provide imaging details of IPMN, including communication of BPD IPMN with MPD, that are almost equivalent to those provided at MRCP. Presence of mural nodules, dilated MPD (�10-mm diameter), or thick septa at CT or MRCP may be used as independent predictors of malignancy.

Item Type: Article
Subjects: Medicine > KMC Manipal > Radiology
Depositing User: KMC Manipal
Date Deposited: 29 Jul 2015 09:43
Last Modified: 29 Jul 2015 09:43
URI: http://eprints.manipal.edu/id/eprint/143643

Actions (login required)

View Item View Item