Imaging features of intraductal papillary mucinous neoplasms of the pancreas in multi-detector row computed tomography.
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.
Tan
Ling
L
Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, 197 Ruijin Er Road, Shanghai 200025, China.
Zhao
Ya-E
YE
Wang
Deng-Bin
DB
Wang
Qing-Bing
QB
Hu
Jing
J
Chen
Ke-Min
KM
Deng
Xia-Xing
XX
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*
Radiology. 2007 Nov;245(2):483-90
17848678
Arch Surg. 2003 Apr;138(4):427-3; discussion 433-4
12686529
Hepatogastroenterology. 1996 May-Jun;43(9):692-709
8799417
Arch Surg. 2004 Feb;139(2):188-92
14769579
Am J Gastroenterol. 2002 Oct;97(10):2553-8
12385438
Cancer. 1992 Mar 15;69(6):1327-33
1540869
Arch Surg. 2002 Nov;137(11):1274-8
12413317
AJR Am J Roentgenol. 2006 Mar;186(3):687-95
16498096
Cancer. 1992 Sep 15;70(6):1505-13
1516002
Radiology. 1998 Jul;208(1):231-7
9646818
Ann Surg. 1998 Nov;228(5):685-91
9833807
Surgery. 2002 Jul;132(1):80-5
12110799
World J Gastroenterol. 2008 May 21;14(19):2977-9
18494045
Int J Pancreatol. 1995 Dec;18(3):197-206
8708390
J Hepatobiliary Pancreat Surg. 2003;10(2):142-6
14505147
Abdom Imaging. 2003 Sep-Oct;28(5):694-9
14628879
Am J Surg. 1998 Mar;175(3):203-8
9560120
Am J Gastroenterol. 2008 Jan;103(1):229-39; quiz 228, 240
18076739
J Gastrointest Surg. 2003 Jan;7(1):12-19
12559180
Eur Radiol. 2001;11(10):1939-51
11702126
Arch Surg. 2001 Nov;136(11):1256-62
11695969
Radiology. 2008 Sep;248(3):876-86
18632526
Eur Radiol. 2005 Sep;15(9):1888-97
15765209
Abdom Imaging. 2006 May-Jun;31(3):320-5
16333711
Br J Surg. 2003 Oct;90(10):1244-9
14515294
AJR Am J Roentgenol. 2000 May;174(5):1403-8
10789803
Ann Surg. 2004 Jun;239(6):788-97; discussion 797-9
15166958
J Gastroenterol. 2005 Jul;40(7):669-75
16082582
Radiology. 2002 Jul;224(1):34-41
12091659
Eur J Surg Oncol. 2007 Aug;33(6):678-84
17207960
Am J Surg Pathol. 2000 Oct;24(10):1372-7
11023098
J Clin Gastroenterol. 2003 Mar;36(3):261-5
12590239
Ann Surg. 2004 May;239(5):678-85; discussion 685-7
15082972
Pancreatology. 2006;6(1-2):17-32
16327281
Radiology. 2006 Feb;238(2):560-9
16436817
Korean J Radiol. 2003 Jul-Sep;4(3):157-62
14530644