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Differential diagnosis of benign and malignant intraductal papillary mucinous tumors of the pancreas: MR cholangiopancreatography and MR angiography.

Choi BS, Kim TK, Kim AY, Kim KW, Park SW, Kim PN, Ha HK, Lee MG, Kim SC - Korean J Radiol (2003 Jul-Sep)

Bottom Line: Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05).Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05).Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tkkim@amc.seoul.kr

ABSTRACT

Objective: To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy.

Materials and methods: During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA.

Results: Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001).

Conclusion: Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas.

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Related in: MedlinePlus

A 60-year-old man with benign main duct-type IPMT of the pancreas. Single-slab MRCP image (TR/TE, infinite/1200) shows diffuse dilatation of the main pancreatic duct (arrows).
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Figure 1: A 60-year-old man with benign main duct-type IPMT of the pancreas. Single-slab MRCP image (TR/TE, infinite/1200) shows diffuse dilatation of the main pancreatic duct (arrows).

Mentions: The MRCP findings for intraductal papillary mucinous tumors are summarized in Table 1. Among the 19 patients with benign IPMT, the main duct type occurred in two (11%) (Fig. 1), the branch duct type in nine (47%) (Fig. 2), and the combined type in eight (42%) (Fig. 3). For the 27 patients with malignant IPMT, the corresponding figures were three (11%), three (11%) (Fig. 4), and 21 (78%) (Fig. 5). The combind type was noticeably more common among malignant tumors (p < 0.05).


Differential diagnosis of benign and malignant intraductal papillary mucinous tumors of the pancreas: MR cholangiopancreatography and MR angiography.

Choi BS, Kim TK, Kim AY, Kim KW, Park SW, Kim PN, Ha HK, Lee MG, Kim SC - Korean J Radiol (2003 Jul-Sep)

A 60-year-old man with benign main duct-type IPMT of the pancreas. Single-slab MRCP image (TR/TE, infinite/1200) shows diffuse dilatation of the main pancreatic duct (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698082&req=5

Figure 1: A 60-year-old man with benign main duct-type IPMT of the pancreas. Single-slab MRCP image (TR/TE, infinite/1200) shows diffuse dilatation of the main pancreatic duct (arrows).
Mentions: The MRCP findings for intraductal papillary mucinous tumors are summarized in Table 1. Among the 19 patients with benign IPMT, the main duct type occurred in two (11%) (Fig. 1), the branch duct type in nine (47%) (Fig. 2), and the combined type in eight (42%) (Fig. 3). For the 27 patients with malignant IPMT, the corresponding figures were three (11%), three (11%) (Fig. 4), and 21 (78%) (Fig. 5). The combind type was noticeably more common among malignant tumors (p < 0.05).

Bottom Line: Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05).Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05).Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tkkim@amc.seoul.kr

ABSTRACT

Objective: To compare the usefulness of magnetic resonance cholangiopancreatography (MRCP) and MR angiography (MRA) in differentiating malignant from benign intraductal papillary mucinous tumors of the pancreas (IPMTs), and to determine the findings which suggest malignancy.

Materials and methods: During a 6-year period, 46 patients with IPMT underwent MRCP. Morphologically, tumor type was classified as main duct, branch duct, or combined. The diameter of the main pancreatic duct (MPD), the extent of the dilated MPD, and the location and size of the cystic lesion, septum, and communicating channel were assessed. For all types of IPMTs, enhanced mural nodules and portal vein narrowing were evaluated at MRA.

Results: Combined-type IPMTs were more frequently malignant (78%) than benign (42%) (p < 0.05). Compared with benign lesions, malignant lesions were larger, and the caliber of the communicating channel was also larger (p < 0.05). Their dilated MPD was more extensive and of greater diameter (p < 0.05), and the presence of mural nodules was more frequent (p < 0.001).

Conclusion: Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas.

Show MeSH
Related in: MedlinePlus