Mass‐forming autoimmune pancreatitis and pancreatic carcinoma: Differential diagnosis on the basis of computed tomography and magnetic resonance cholangiopancreatography, and diffusion‐weighted imaging findings

Journal of Magnetic Resonance Imaging - Tập 35 Số 4 - Trang 827-836 - 2012
Ali Muhi1,2, Tomoaki Ichikawa2, Utaroh Motosugi2, Hironobu Sou2, Katsuhiro Sano2, Tatsuaki Tsukamoto2, Zareen Fatima2, Tsutomu Araki2
1Department of Radiology, University of Muthanna, Al Muthanna, Iraq
2Department of Radiology, University of Yamanashi, Yamanshi, Japan

Tóm tắt

AbstractPurpose:To differentiate mass‐forming autoimmune pancreatitis (AIP) from pancreatic carcinoma by means of analysis of both computed tomography (CT) and magnetic resonance imaging (MRI) findings.Materials and Methods:Ten patients with mass‐forming AIP diagnosed by revised clinical criteria of Japan Pancreas Society and 70 patients with pathologically proven pancreatic carcinoma were enrolled in this retrospective study. Two radiologists independently evaluated the CT and MR imaging findings. The sensitivity, specificity, and odds ratio of significant imaging findings and combinations of findings were calculated.Results:Seven findings were more frequently observed in AIP patients: (i) early homogeneous good enhancement, (ii) delayed homogeneous good enhancement, (iii) hypoattenuating capsule‐like rim, (iv) absence of distal pancreatic atrophy, (v5) duct penetrating sign, (vi) main pancreatic duct (MPD) upstream dilatation ≤ 4 mm, and (vii) an apparent diffusion coefficient (ADC) ≤ 0.88 × 10−3 mm2/s. When the findings of delayed homogeneous enhancement and ADC ≤ 0.88 × 10−3 mm2/s were both used in diagnosis of mass‐forming AIP, a sensitivity of 100% and a specificity of 100% were achieved. When 4 of any of the 7 findings were used in the diagnosis of AIP, a sensitivity of 100% and a specificity of 98% were achieved.Conclusion:Analysis of a combination of CT and MR imaging findings allows for highly accurate differentiation between mass‐forming AIP and pancreatic carcinoma. J. Magn. Reson. Imaging 2012;35:827–836. © 2011 Wiley Periodicals, Inc.

Từ khóa


Tài liệu tham khảo

10.1007/s00535-006-1868-0

10.3748/wjg.v12.i16.2487

10.1016/j.cgh.2006.05.017

10.1111/j.1572-0241.2003.08775.x

10.1148/radiol.2332031436

10.2214/ajr.170.5.9574610

10.1097/MPA.0b013e318175e3a0

10.2214/ajr.183.4.1830915

10.1159/000055819

10.1097/00006676-200210000-00011

10.1111/j.1572-0241.2003.08727.x

10.1007/s00261-005-0047-8

10.1007/s003300000742

10.3748/wjg.v12.i18.2919

10.2214/ajr.170.3.9490945

10.1097/MPA.0b013e31818d92c0

10.1111/j.1572-0241.2004.40215.x

10.1111/j.1572-0241.2007.01264.x

10.1097/00000478-200301000-00012

10.1097/01.SLA.0000071516.54864.C1

10.1016/S1091-255X(02)00148-8

Declaration of Helsinki, 2009, Ethical principles for medical research involving human subjects, J Indian Med Assoc, 107, 403

10.3748/wjg.14.4992

10.2214/AJR.08.1883

10.1148/radiol.2211001157

10.1038/ajg.2010.87

10.1002/jmri.21508

10.1002/jmri.21651

10.1097/mpa.0b013e318135483d

Thông tin
Thông tin xuất bản

Journal of Magnetic Resonance Imaging

Tập 35 Số 4

827-836

Thông tin tác giả