title: Ultrasonographic characteristics of intraductal papillary mucinous neoplasm of the pancreas.
abstract: OBJECTIVE
  To analyze the clinical and ultrasonographic imaging features of intraductal papillary mucinous neoplasm (IPMN) of the pancreas.
  
  
  METHODS
  Twelve patients with IPMN underwent surgery between May 2005 and December 2008, including 4 (33.3%) with adenoma and 8 (66.7%) with adenocarcinoma. IPMN was classified preoperatively into 3 types based on sonographic findings of different sites: main duct, branch duct, and combined type. All clinical presentations and ultrasonographic findings of those patients were reviewed and the correlation between ultrasonographic findings and histopathological results was analyzed.
  
  
  RESULTS
  There were 9 men and 3 women with a mean age of 60.1 +/- 9.6 years (range, 32-73). Of all the 12 patients with IPMN, 9 (75.0%) had experienced some symptoms of epigastric discomfort and/or pain as well as backache; 7 cases were with medical history of acute pancreatitis, 5 cases with diabetes, 4 cases with elevated CA19-9, and 2 cases with steatorrhea. All lesions of IPMN have been revealed by transabdominal ultrasonography. The mean diameters of the lesions were 1.4 +/- 0.8 cm (range, 0.5-2.0) and 6.3 +/- 6.0 cm (range, 2.0-20.0) in adenomas and adenocarcinomas, respectively. And the mean diameters of the main duct in adenomas and adenocarcinomas were 1.0 +/- 0.8 cm and 1.6 +/- 1.0 cm, respectively. Among the 4 adnomas, 3 (75.0%) cases were classified as branch type based on sonographic findings, and 2 were demonstrated as mural nodules in which no color signals was detected. Among the 8 adenocarcinomas, 5 (62.5%) cases were classified as main duct type, and 3 (37.5%) as combined type. In 7 of the 8 adenocarcinomas, mural nodules were detected within the dilated ducts or cysts of the lesions in which color flow signals were detected.
  
  
  CONCLUSIONS
  Transabdominal ultrasonography can reveal the pancreatic cystic lesions of IPMN as well as dilated pancreatic ducts. Some characteristics should be noticed as suggesting the possibility of malignancy: clinical symptoms of pancreatic insufficiency, large tumor size, and mural nodules with color Doppler flow signals. Transabdominal ultrasonography could be a useful tool to help diagnose and make appropriate management of IPMN.
authors.affiliation: Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Lü
authors.forename: Qing
authors.initials: Q
authors.lastname: Dai
authors.forename: Zhong-Hui
authors.initials: ZH
authors.lastname: Xu
authors.forename: Yi-Xiu
authors.initials: YX
authors.lastname: Zhang
authors.forename: Li
authors.initials: L
authors.lastname: Tan
authors.forename: Yan
authors.initials: Y
authors.lastname: Yuan
authors.forename: Yu-Xin
authors.initials: YX
authors.lastname: Jiang
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010181:Pancreatic Cyst / Q000000981:diagnostic imaging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography