title: CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs).
abstract: OBJECTIVE
  To describe CT and MR imaging findings of acinar cell cystadenoma (ACC) of the pancreas and to compare them with those of branch duct intraductal papillary mucinous neoplasia (BD-IPMN) to identify distinctive elements.
  
  
  METHODS
  Five patients with ACC and the 20 consecutive patients with histologically proven BD-IPMN were retrospectively included. Clinical and biological information was collected and histological data reviewed. CT and MR findings were analysed blinded to pathological diagnosis in order to identify imaging diagnostic criteria of ACC.
  
  
  RESULTS
  Patients with ACC were symptomatic in all but one case and were younger than those with BD-IPMN (p = 0.006). Four radiological criteria allowed for differentiating ACC from IPMN: five or more cysts, clustered peripheral small cysts, presence of cyst calcifications and absence of communication with the main pancreatic duct (p < 0.05). Presence of at least two or three of these imaging criteria had a strong diagnostic value for ACC with a sensitivity of 100% and 80% and a specificity of 85% and 100%, respectively.
  
  
  CONCLUSIONS
  Preoperative differential diagnosis between ACC and BD-IPMN can be achieved using a combination of four CT and/or MR imaging criteria. Recognition of ACC patients could change patient management and lead to more conservative treatment.
  
  
  CONCLUSIONS
  Four imaging findings are associated with acinar cell cystadenoma (ACC). Imaging could achieve differential diagnosis between ACC and BD-IPMN. Diagnosis on imaging would change patient management and avoid surgical resection.
authors.affiliation: Service de Radiologie, Hôpital Beaujon, 100, Boulevard du Général Leclerc, 92118, Clichy Cedex, France, christophe.delavaud@hotmail.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Delavaud
authors.forename: Gaspard
authors.initials: G
authors.lastname: d'Assignies
authors.forename: Jérome
authors.initials: J
authors.lastname: Cros
authors.forename: Philippe
authors.initials: P
authors.lastname: Ruszniewski
authors.forename: Pascal
authors.initials: P
authors.lastname: Hammel
authors.forename: Philippe
authors.initials: P
authors.lastname: Levy
authors.forename: Anne
authors.initials: A
authors.lastname: Couvelard
authors.forename: Alain
authors.initials: A
authors.lastname: Sauvanet
authors.forename: Safi
authors.initials: S
authors.lastname: Dokmak
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Vullierme
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000328:Adult; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis*; D049448:Cholangiopancreatography, Magnetic Resonance / Q000379:methods*; D018292:Cystadenoma, Papillary / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies