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Validation of the 2012 International Consensus Guidelines Using Computed Tomography and Magnetic Resonance Imaging: Branch Duct and Main Duct Intraductal Papillary Mucinous Neoplasms of the Pancreas

Authors
 Seo, Nieun  ;  Byun, Jae Ho  ;  Kim, Jin Hee  ;  Kim, Hyoung Jung  ;  Lee, Seung Soo  ;  Song, Ki Byung  ;  Kim, Song-Cheol  ;  Han, Duck Jong  ;  Hong, Seung-Mo  ;  Lee, Moon-Gyu 
Citation
 Annals of Surgery, Vol.263(3) : 557-564, 2016 
Journal Title
 Annals of Surgery 
ISSN
 0003-4932 
Issue Date
2016
Abstract
OBJECTIVE: To validate the 2012 guidelines for intraductal papillary mucinous neoplasm (IPMN) of the pancreas and to compare diagnostic performances of computed tomography (CT) and magnetic resonance imaging (MRI) for differentiating malignant from benign IPMN. BACKGROUND: As IPMN has variable risks of malignancy and management of this entity is closely related to its malignant potential, it is important to predict risks of IPMN malignancy. METHODS: This retrospective study included 158 patients with surgically confirmed IPMN of the pancreas who underwent both preoperative CT and MRI. Two radiologists evaluated the ""high-risk stigmata"" and ""worrisome features"" of the 2012 guidelines for branch duct (BD)-IPMN and main duct (MD)-IPMN. Univariate and multivariable analyses were used to identify significant predictors of malignancy in IPMN. The diagnostic performance was compared between CT and MRI. RESULTS: Malignant IPMN was seen in 8 of 60 patients (13.3%) with BD-IPMN and 44 of 98 patients (44.9%) with MD-IPMN. Presence of mural nodule was the most important predictor in BD-IPMN and MD-IPMN (odds ratios, 9.2 and 7.6, respectively, P = 0.01 on CT; and odds ratios, 5.7 and 13.3, respectively, P ≤ 0.04 on MRI), whereas mural nodule size and lymphadenopathy were significant only in MD-IPMN (P < 0.05). The diagnostic performance of CT and MRI for significant findings was not statistically different in both types of IPMN (P > 0.34). CONCLUSIONS: The presence of mural nodule was the most important predictor of malignancy in both types of IPMN. Mural nodule size and lymphadenopathy were also significant predictors in MD-IPMN. Computed tomography and MRI showed similar diagnostic performances for differentiating malignant from benign IPMN.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00000658-201603000-00020&LSLINK=80&D=ovft
DOI
10.1097/SLA.0000000000001217
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
서니은(Seo, Nieun) ORCID logo https://orcid.org/0000-0001-8745-6454
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152957
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