Comparison between multislice CT and MR imaging in the diagnostic evaluation of patients with pancreatic masses.
OBJECTIVE
This study compared the results of multislice computed tomography (MSCT) and high-field magnetic resonance imaging (MRI) in the diagnostic evaluation of pancreatic masses.


METHODS
Forty patients with clinical and ultrasonographic evidence of pancreatic masses underwent MSCT and MRI. The majority of patients (31/40, 78%) had proven malignant pancreatic tumours (24 ductal adenocarcinoma, six mucinous cystadenocarcinoma, one intraductal papillary mucinous carcinoma), whereas the remaining patients (9/40, 22%) were found to have benign lesions (eight chronic pancreatitis, one serous cystadenoma). Results of the imaging studies were compared with biopsy (n=33) and/or histology (n=7) findings to calculate sensitivity, specificity, accuracy and positive (PPV) and negative (NPV) predictive value for correct identification of tumours and evaluation of resectability of malignancies.


RESULTS
Both for tumour identification and resectability, MSCT and MRI had comparable diagnostic accuracy, with no statistically significant differences between them. Tumour identification CT/MRI: accuracy 98/98%, sensitivity 100/100%, specificity 88/88%, PPV 97/97%, NPV 100/100%; tumour resectability CT/MRI: accuracy 94/90%, sensitivity 92/88%, specificity 100/100%, PPV 100/100%, NPV 78/70%.


CONCLUSIONS
MRI represents a valid diagnostic alternative to CT in the evaluation of patients with pancreatic masses, both for correct identification and characterisation of primary lesions and to establish resectability in the case of malignancies. New high-field MRI equipment allows optimal imaging quality with good contrast resolution in evaluating the upper abdomen.
Fusari
M
M
Dipartimento di Scienze Biomorfologiche e Funzionali (DSBMF), Università degli Studi di Napoli Federico II (UNINA), Istituto di Biostrutture e Bioimmagini (IBB), Consiglio Nazionale delle Ricerche (CNR), Fondazione SDN (IRCCS), Napoli, Italy.
Maurea
S
S
Imbriaco
M
M
Mollica
C
C
Avitabile
G
G
Soscia
F
F
Camera
L
L
Salvatore
M
M
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis / Q000000981:diagnostic imaging; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000000981:diagnostic imaging; D003287:Contrast Media; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography
D003287:Contrast Media