Intraductal Papillary Mucinous Neoplasms of the Pancreas: Correlation of Helical Computed Tomography (CT) Features With Pathologic Findings.
Intraductal papillary mucinous neoplasms (IPMNs) are precancerous lesions of the pancreas. Computed tomography (CT) has been recommended to screen the malignant potential of IPMNs. However, data evaluating the use of CT to differentiate categories of IPMN based on disease progression are limited. This study aimed to explore the correlation between CT characteristics and pathology in IPMN associated with invasive carcinoma.



A total of 31 patients with intraductal papillary mucinous carcinoma (IPMC) treated at one local regional hospital in Shanghai, China, were enrolled in this study. Patients were divided into two groups based on invasion component and characterized as follows: group A, an invasive component of less than 50% (IPMC-I); and group B, with invasion of 50% or greater and defined as pancreatic ductal adenocarcinoma associated with IPMN (PDAC-IPMN). First, we analyzed the imaging information of the 31 patients retrospectively. Then, we compared the imaging differences between the two groups.



Fifteen patients with IPMC-1 and 16 patients with PDAC-IPMN were identified. There was no statistically significant difference in sex, age, lesion location, radiologic type, tumor size, mural nodule size, and lymphatic metastasis between the two groups. However, the arterial increased CT values were significantly different between the two groups (P < .01), with values of 29.2 ± 12.4 HU for group A and 14.2 ± 8.8 HU for group B. The venous increased CT values were 44.6 ± 12.0 HU for group A and 28.4 ± 12.3 HU for group B, and these were significantly different between the two groups (P < .01). In group A, 13 cases (86.7%) were classified as T1 or T2 stage, and in group B, eight cases (50.0%) were classified as T1 and T2 stage. There was a statistically significant difference in tumor classification between group A and group B patients (P < .05).



IPMC-I and PDAC-IPMN have different characteristics in CT imaging, and we demonstrated that CT scans based on blood supply and lymphatic metastasis could be used to evaluate and potentially screen for variation in IPMC disease outcomes.
Department of Radiology, Dezhou People's Hospital, Dezhou, China.
Wanbo
W
Xu
Department of Pharmacy, Dezhou People's Hospital, Dezhou, China.
Xiaojin
X
Liu
Department of Radiology, Huashan Hospital of Fudan University, 12 WuLuMuQi Rd, Shanghai, China. Electronic address: xiaojin8208@163.com.
Jiawen
J
Zhang
Department of Medical Imaging and Nuclear Medicine, Fudan University, Shanghai, China.
Li
L
Yang
D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000601:surgery; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D010179:Pancreas / Q000473:pathology* / Q000601:surgery; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*
CT scan; Pancreas; computed tomography; intraductal papillary mucinous neoplasms