title: MR cholangiopancreatographic differentiation of benign and malignant intraductal mucin-producing tumors of the pancreas.
abstract: OBJECTIVE
  The purpose of this study was to establish MR cholangiopancreatographic criteria for discriminating benign from malignant intraductal mucin-producing tumors of the pancreas.
  
  
  METHODS
  Thirty-one patients with 34 intraductal mucin-producing tumors underwent MR cholangiopancreatography. Tumors were classified as either main duct type (n = 10) or branch duct type (n = 24). In patients with the main duct type, the maximum diameter and the location of the main pancreatic duct, the extent of main pancreatic duct dilatation, and the presence of a filling defect were evaluated. For branch duct type, the location and maximum diameter of the cystic lesion, the presence of a filling defect, and the presence of associated main pancreatic duct dilatation were evaluated.
  
  
  RESULTS
  In patients with the main duct type, the main pancreatic duct was significantly narrower when associated with benign rather than malignant tumors. All malignant tumors showed diffuse main pancreatic duct dilatation, whereas all benign tumors showed segmental dilatation. Among patients with branch duct type, the cyst was smaller when it was a benign rather than malignant tumor. All but one malignant tumor showed mild associated main pancreatic duct dilatation, whereas benign tumors were not associated with main pancreatic duct dilatation. Filling defects suggested malignancy, although half of the malignant tumors had no filling defects.
  
  
  CONCLUSIONS
  In patients with intraductal mucin-producing tumors of the pancreas, filling defects are indicative of malignancy. Diffuse main pancreatic duct dilatation greater than 15 mm (main duct type), or any main pancreatic duct dilatation (branch duct type), is strongly associated with malignancy.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Irie
authors.forename: H
authors.initials: H
authors.lastname: Honda
authors.forename: H
authors.initials: H
authors.lastname: Aibe
authors.forename: T
authors.initials: T
authors.lastname: Kuroiwa
authors.forename: K
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: K
authors.initials: K
authors.lastname: Shinozaki
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: M
authors.initials: M
authors.lastname: Shimada
authors.forename: K
authors.initials: K
authors.lastname: Masuda
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism; D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism; D000368:Aged; D001652:Bile Ducts / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009077:Mucins / Q000378:metabolism*; D010179:Pancreas / Q000473:pathology*; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D009077:Mucins