title: Imaging features of intraductal papillary mucinous neoplasms of the pancreas in multi-detector row computed tomography.
abstract: OBJECTIVE
  To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).
  
  
  METHODS
  A total of 20 patients with pathologically-confirmed intraductal papillary mucinous neoplasms (IPMNs) were included in this study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume reformations (MPVR) or curved reformations (CR) were preoperatively acquired. Two radiologists (Tan L and Wang DB) reviewed all the images in consensus using an interactive picture archiving and communication system. The disputes in readings were resolved through consultation with a third experienced radiologist (Chen KM). Finally, the findings and diagnoses were compared with the pathologic results.
  
  
  RESULTS
  The pathological study revealed 12 malignant IPMNs and eight benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs (P < 0.05). The combined-type IPMNs had a higher rate of malignancy than the other two types of IPMNs (P < 0.05). Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features (P < 0.05). Communication of side-branch IPMNs with the MPD was present in nine cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5% and 95%, respectively.
  
  
  CONCLUSIONS
  MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.
authors.affiliation: Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, 197 Ruijin Er Road, Shanghai 200025, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Tan
authors.forename: Ya-E
authors.initials: YE
authors.lastname: Zhao
authors.forename: Deng-Bin
authors.initials: DB
authors.lastname: Wang
authors.forename: Qing-Bing
authors.initials: QB
authors.lastname: Wang
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
authors.forename: Ke-Min
authors.initials: KM
authors.lastname: Chen
authors.forename: Xia-Xing
authors.initials: XX
authors.lastname: Deng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009362:Neoplasm Metastasis; D015588:Observer Variation; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
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