Use of multidetector-row computed tomography to evaluate branch duct type intraductal papillary mucinous neoplasms of the pancreas: influence on surgical decision-making.
OBJECTIVE
The purpose of this study was to evaluate factors predictive of the malignant grade associated with branch duct type intraductal papillary mucinous neoplasm (BD-IPMN) using multidetectorrow computed tomography (MDCT).


METHODS
We reviewed the morphological features of 26 BDIPMNs using MDCT. Tumor size, caliber of the main pancreatic duct, number of mural nodules, diameter of the largest mural nodule and volume of the largest mural nodule were assessed and correlated with the pathological findings.


RESULTS
By multiple- and single-regression analyses and Mann-Whitney U test, significant differences in the caliber of the main pancreatic duct and number of mural nodules were observed between adenoma and non-invasive carcinoma and in the number of mural nodules between adenoma and invasive carcinoma. No significant differences were observed between non-invasive carcinoma and invasive carcinoma. Based on the differential diagnostic criterion of 1 or more mural nodules for distinguishing adenoma from non-invasive carcinoma and invasive carcinoma, the sensitivities were 60% and 100%, respectively, and the specificity was 93% for both.


CONCLUSIONS
Although it was impossible to distinguish non-invasive carcinoma from invasive carcinoma, MDCT was reliable for distinguishing adenoma from non-invasive carcinoma and invasive carcinoma.
Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. ishii0512h@yahoo.co.jp
Hiromichi
H
Ishii
Hiroki
H
Taniguchi
Atsushi
A
Shiozaki
Yoshiaki
Y
Kuriu
Hisashi
H
Ikoma
Masayoshi
M
Nakanishi
Daisuke
D
Ichikawa
Hitoshi
H
Fujiwara
Kazuma
K
Okamoto
Toshiya
T
Ochiai
Yukihito
Y
Kokuba
Chohei
C
Sakakura
Teruhisa
T
Sonoyama
Eigo
E
Otsuji
D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed