title: Bull's-eye pattern of pancreatic-duct stones on multidetector computed tomography and gene-mutation-associated pancreatitis (GMAP).
abstract: OBJECTIVE
  This study prospectively assessed whether the presence of a bull's-eye pattern of pancreatic-duct stones on multidetector computed tomography (MDCT) correlated with gene-mutation-associated pancreatitis (GMAP) and whether other signs suggestive of GMAP can be detected with MDCT.
  
  
  METHODS
  Forty-seven patients with chronic calcific pancreatitis underwent genetic testing for CFTR, SPINK1 and PRSS1 mutations and an MDCT scan of the abdomen. Qualitative analysis assessed the presence or absence of pancreatic-duct stones with bull's-eye appearance. Quantitative analysis included the number and maximum diameter of stones and the diameter of the main pancreatic duct.
  
  
  RESULTS
  Fifteen of 47 patients (32%) were positive for gene mutations (GMAP patients). The bull's-eye pattern was found in 10/15 patients (67%) with GMAP and in 4/32 (12%) patients with chronic pancreatitis not associated with GMAP (NGMAP; p<0.0001). The mean diameter of duct stones was 15 mm in patients with GMAP and 10 mm in patients with NGMAP (p<0.04).
  
  
  CONCLUSIONS
  The presence of duct stones with a bull's-eye pattern correlates with GMAP. Duct stones with diameter ≥15 mm are another sign suggestive of GMAP.
authors.affiliation: Istituto di Radiologia, Università di Verona, P.le L.A. Scuro 10, 37134, Verona, Italy. rossella.paola.graziani@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Graziani
authors.forename: L
authors.initials: L
authors.lastname: Frulloni
authors.forename: C
authors.initials: C
authors.lastname: Cicero
authors.forename: R
authors.initials: R
authors.lastname: Manfredi
authors.forename: M C
authors.initials: MC
authors.lastname: Ambrosetti
authors.forename: S
authors.initials: S
authors.lastname: Mautone
authors.forename: R
authors.initials: R
authors.lastname: Pozzi Mucelli
mesh_terms: D000328:Adult; D000368:Aged; D002137:Calculi / Q000000981:diagnostic imaging* / Q000235:genetics; D002352:Carrier Proteins / Q000235:genetics; D003287:Contrast Media; D019005:Cystic Fibrosis Transmembrane Conductance Regulator / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009154:Mutation; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging*; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging* / Q000235:genetics; D014357:Trypsin / Q000235:genetics; D014359:Trypsin Inhibitor, Kazal Pancreatic; D055815:Young Adult
chemical_list: D002352:Carrier Proteins; D003287:Contrast Media; C486642:SPINK1 protein, human; D019005:Cystic Fibrosis Transmembrane Conductance Regulator; D014359:Trypsin Inhibitor, Kazal Pancreatic; C489303:PRSS1 protein, human; D014357:Trypsin