title: Management of branch duct-type intraductal papillary mucinous tumor of the pancreas based on magnetic resonance imaging.
abstract: BACKGROUND
  We assessed the usefulness of magnetic resonance imaging (MRI) in identifying nonmalignant intraductal papillary mucinous tumors (IPMTs) of the pancreas.
  
  
  METHODS
  Thirty-three patients with branch duct-type IPMT diagnosed by endoscopic retrograde cholangiopancreatography were prospectively examined with magnetic resonance cholangiopancreatography followed by dynamic gadolinium-enhanced MRI examinations, and patients with no findings suggestive of malignancy, including a solid mass, mural nodules, a main pancreatic duct wider than 5 mm in diameter, and stenosis of the main pancreatic duct, were prospectively followed up with sequential MRI examinations once or twice a year.
  
  
  RESULTS
  Twenty-six (79%) patients showed no findings suggestive of malignancy in the initial MRI examination. The diameter (mean +/- standard error) of the main pancreatic duct was 3.9 +/- 0.7 mm and that of the ectatic branch pancreatic duct was 36.0 +/- 9.1 mm. Twenty-three patients were prospectively followed for more than 36 months and 22 of them showed no findings suggestive of malignancy during follow-up periods ranging from 39 to 77 months (mean = 55 months).
  
  
  CONCLUSIONS
  MRI was useful to identify nonmalignant IPMTs of the branch duct type, and close follow-up observation with serial MRI examinations may be appropriate in the management of such patients.
authors: Department of Gastroenterology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
authors: J K
authors: JK
authors: Sai
authors: M
authors: M
authors: Suyama
authors: Y
authors: Y
authors: Kubokawa
authors: K
authors: K
authors: Yamanaka
authors: H
authors: H
authors: Tadokoro
authors: Y
authors: Y
authors: Iida
authors: N
authors: N
authors: Sato
authors: K
authors: K
authors: Suda
authors: B
authors: B
authors: Nobukawa
authors: T
authors: T
authors: Maehara
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000231:Adenocarcinoma, Papillary / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media