Usefulness of multidetector computed tomography for detecting protruding lesions in intraductal papillary mucinous neoplasm of the pancreas in comparison with single-detector computed tomography and endoscopic ultrasonography.
OBJECTIVE
To retrospectively evaluate the usefulness of multidetector computed tomography (MDCT) with multiplanar reformations (MPRs) and curved planar reformations (CPRs) for detecting protruding lesions in intraductal papillary mucinous neoplasms of the pancreas (IPMNs) as compared with single-detector CT (SDCT) and endoscopic ultrasonography (EUS).


METHODS
Eighty-six patients with IPMNs were imaged either with SDCT (n = 52) or MDCT with MPRs/CPRs and EUS (n = 34). The diagnostic accuracy of each imaging modality for identifying protruding lesions was compared with histological samples.


RESULTS
Among the patients in whom protruding lesions were histopathologically identified, the lesions were detected in 9 of the 33 patients subjected to SDCT (51.9% accuracy), in 17 of the 25 patients subjected to MDCT with MPRs and CPRs (76.5% accuracy), and in 21 of the 25 patients subjected to EUS (70.6% accuracy). Thus, significant difference was observed between MDCT and SDCT regarding accuracy (P < 0.05); however, no significant difference was seen between MDCT and EUS. Protruding lesions of less than 10 mm in height were better visualized with MDCT (53.3%) than with SDCT (13.0%; P < 0.05).


CONCLUSIONS
Multidetector computed tomography proved more useful than SDCT and equivalent to EUS in detecting protruding lesions in IPMNs.
Nakagawa
Akihiko
A
Department of Gastroenterology, Numazu Municipal Hospital, Shizuoka, Japan.
Yamaguchi
Taketo
T
Ohtsuka
Masayuki
M
Ishihara
Takeshi
T
Sudo
Kentaro
K
Nakamura
Kazuyoshi
K
Hara
Taro
T
Denda
Tadamichi
T
Miyazaki
Masaru
M
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000473:pathology*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*