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


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).


CONCLUSIONS
Combined MRCP and MRA might be useful for the differential diagnosis of malignant and benign IPMTs of the pancreas.
Choi
Byung Se
BS
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tkkim@amc.seoul.kr
Kim
Tae Kyoung
TK
Kim
Ah Young
AY
Kim
Kyoung Won
KW
Park
Sung Won
SW
Kim
Pyo Nyun
PN
Ha
Hyun Kwon
HK
Lee
Moon-Gyu
MG
Kim
Song Cheol
SC
D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D003287:Contrast Media; D018291:Cystadenoma, Mucinous / Q000175:diagnosis*; D018292:Cystadenoma, Papillary / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*
D003287:Contrast Media; D019786:Gadolinium DTPA