[CT and pathological manifestations of intraductal papillary mucinous neoplasm of pancreas: a comparative study].
OBJECTIVE
To evaluate the diagnostic value of CT in pancreas intraductal papillary mucinous neoplasm (IPMN) by analyzing its CT feature and pathological findings.


METHODS
The clinical and CT data was analyzed among 39 patients with IPMN whose diagnosis was confirmed by pathology. The CT manifestations were classified into 3 types: simple main pancreatic duct enlargement; main pancreatic duct enlargement combined with pancreatic cystic lesion; and simple pancreatic cystic lesion. The correlation between the CT types and Takada pathological types (main duct type, branch type, and mixed type) was analyzed. All the cases were pathologically classified into benign and malignant/boundary groups. Statistical tests of the difference of CT features (mural nodule, septa, size, caliber of main pancreatic duct and common bile duct) between the 2 groups were performed.


RESULTS
The CT type I matched the main duct type, the CT type II mainly matched the branch type and mixed type, and the CT type III matched the branch type (P < 0.001). The probability of benign lesion was 92% with no mural nodule in the lesion, while the probability of benign lesion was only 42% with mural nodule presented (P = 0.003). In terms of the septa, there was no significant difference between benign and malignant lesions (P = 0.793). The size of malignant/boundary lesions exceeded that of benign lesions (P = 0.016). There were no significant difference in calibers of main pancreatic duct and common bile duct between the benign and malignant/ boundary groups. Without considering pathological grouping the caliber of main pancreatic duct exceeded that of the common bile duct in all the cases (P = 0.02).


CONCLUSIONS
CT typing of IPMN well matches the pathological typing which benefits the CT diagnosis of IPMN. The caliber of main pancreatic duct usually exceeds that of common bile duct in IPMN. This feature contributes to its diagnosis.
Zhang
Jing
J
Department of Radiology, Tongji Hospital of Tongji University, Shanghai 200065, China.
Wang
Pei-Jun
PJ
Yuan
Xiao-Dong
XD
Shao
Cheng-Wei
CW
Zhao
Xiao-Hu
XH
Xu
Wei-Guo
WG
Dong
Ning-Xin
NX
Wang
Guo-Liang
GL
Shao
Zhi-Hong
ZH
Huang
Zong-Liang
ZL
Zhang
Wei
W