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Differential Diagnosis of Periampullary Carcinomas at MR Imaging

 Joo Hee Kim  ;  Myeong-Jin Kim  ;  Jae-Joon Chung  ;  Woo Jung Lee  ;  Hyung Sik Yoo  ;  Jong Tae Lee 
 RADIOGRAPHICS, Vol.22(6) : 1335-1352, 2002 
Journal Title
Issue Date
Ampulla of Vater/pathology* ; Carcinoma/diagnosis* ; Common Bile Duct Neoplasms/diagnosis* ; Diagnosis, Differential ; Dilatation, Pathologic ; Duodenal Neoplasms/diagnosis* ; Humans ; Magnetic ResonanceImaging/methods* ; Pancreatic Neoplasms/diagnosis*
Bile ducts ; neoplasms ; Duodenum ; neoplasms ; Magnetic resonance (MR) ; cholangiopancreatography ; Pancreas ; neopla는
Periampullary carcinomas arise within 2 cm of the major duodenal papilla and comprise carcinomas of the ampulla, distal common bile duct, pancreas, and duodenum. Their clinical features and anatomic locations are similar, as are the therapeutic approaches; however, their long-term outcomes vary. Magnetic resonance (MR) images of 89 pathologically proved periampullary carcinomas (29 ampullary carcinomas, 27 distal common bile duct carcinomas, 21 pancreatic carcinomas, six duodenal carcinomas, and six unclassified carcinomas) were reviewed. Ampullary carcinoma manifests as a small mass, periductal thickening, or bulging of the duodenal papilla. Pancreatic carcinoma is characterized by a discrete parenchymal mass, which enhances poorly on dynamic gadolinium-enhanced images. Sometimes, two proximal and two distal pancreatic and biliary ducts appear as four separate ducts (the four-segment sign). Dilatation of side branches of the pancreatic ducts is frequently seen in pancreatic carcinoma but not in other periampullary carcinomas. Distal bile duct carcinoma manifests as luminal obliteration and wall thickening or as an intraductal polypoid mass. A dilated proximal bile duct, a nondilated distal bile duct, and a dilated or nondilated pancreatic duct may form the three-segment sign. MR cholangiopancreatography and sectional MR imaging are useful in determining the origins of periampullary carcinomas.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Yoo, Hyung Sik(유형식)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Lee, Jong Tae(이종태)
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
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