title: Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients.
abstract: BACKGROUND
  The study was conducted to evaluate the frequencies of the anatomic variations and the gender distributions of these variations of the pancreatic duct and their relevance with the Cambridge classification system as morphological sign of chronic pancreatitis using magnetic resonance cholangiopancreatography (MRCP).
  
  
  METHODS
  We retrospectively reviewed 1312 consecutive patients who referred to our department for MRCP between January 2013 and August 2015. We excluded 154 patients from the study because of less than optimal results due to imaging limitations or a history of surgery on pancreas. Finally a total of 1158 patients were included in the study.
  
  
  RESULTS
  Among the 1158 patients included in the study, 54 (4.6%) patients showedpancreas divisum, 13 patients (1.2%) were defined asansa pancreatica. When we evaluated the course of the pancreatic duct, we found the prevalence 62.5% for descending, 30% for sigmoid, 5.5% for vertical and 2% for loop. The most commonly observed pancreatic duct configuration was Type 3 in 528 patients (45.6%) where 521 patients (45%) had Type 1 configuration.
  
  
  CONCLUSIONS
  Vertical course (p = 0.004) and Type 2 (p = 0.03) configuration of pancreatic duct were more frequent in females than males. There were no statistically significant differences between the gender for the other pancreatic duct variations such aspancreas divisium, ansa pancreaticaand course types other than vertical course (p > 0.05 for all). Variants ofpancreas divisumand normal pancreatic duct variants were not associated with morphologic findings of chronic pancreatitis by using the Cambridge classification system. Theansa pancreaticais a rare type of anatomical variation of the pancreatic duct, which might be considered as a predisposing factor to the onset of idiopathic pancreatitis.
authors.affiliation: Department of Radiology, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Zehra Hilal
authors.initials: ZH
authors.lastname: Adibelli
authors.affiliation: Department of Radiology, Urfa Balõklõgol State Hospital, Urfa, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Adatepe
authors.affiliation: Department of Radiology, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Cetin
authors.initials: C
authors.lastname: Imamoglu
authors.affiliation: Department of Radiology, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Ozgur Sipahi
authors.initials: OS
authors.lastname: Esen
authors.affiliation: Department of Surgery, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Nazif
authors.initials: N
authors.lastname: Erkan
authors.affiliation: Department of Surgery, Bozyaka Training and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yildirim
keywords: magnetic resonance cholangiopancreatography; magnetic resonance imaging; pancreas divisum; pancreatic duct variants