title: Evaluation of serial changes of pancreatic branch duct intraductal papillary mucinous neoplasms by follow-up with magnetic resonance imaging.
abstract: The purpose of this study was to clarify the biological behaviour of branch duct type intraductal papillary mucinous neoplasm (IPMN) by evaluating serial changes at magnetic resonance cholangiopancreatography (MRCP). Fifty-two patients with a diagnosis of branch duct IPMN based on either endoscopic retrograde cholangiopancreatography (ERCP) (9/52) and/or MRCP examination (43/52), were followed up over a mean period of 31.2 months (range 12-108). All imaging data were retrospectively reviewed by two radiologists in order to evaluate serial changes in the maximum diameter of the cystic lesion, in the presence of main pancreatic duct dilatation (MPD), and filling defects within the lesion. Statistical analysis was performed using the Fisher exact probability test. Serial MRCP proved growth in seven cases. In two cases the size decreased; in the remaining 43 there was no change in size. Lesions greater than 3 cm at presentation and the presence of MPD dilatation or filling defects at imaging were most likely to grow. Only 2/37 cystic lesions less than 3 cm in diameter grew in size over the period of observation. No cystic lesion showed changes in morphology and structure. Branch duct IPMNs smaller than 3 cm, without associated filling defects, tend to be stable, making 'watch and wait' management possible.
authors.affiliation: Radiological Department, General Hospital Ca' Foncello, Treviso, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Guarise
authors.forename: Niccolò
authors.initials: N
authors.lastname: Faccioli
authors.forename: Mauro
authors.initials: M
authors.lastname: Ferrari
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvia
authors.forename: Roberto Pozzi
authors.initials: RP
authors.lastname: Mucelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Morana
authors.forename: Alec J
authors.initials: AJ
authors.lastname: Megibow
mesh_terms: D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D049448:Cholangiopancreatography, Magnetic Resonance; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors