Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP

Clin Imaging. 2017 Jan-Feb:41:137-143. doi: 10.1016/j.clinimag.2016.10.020. Epub 2016 Oct 29.

Abstract

Purpose: To define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis.

Materials-methods: S-MRCPs of 35 patients with pancreatitis and 14 with adenocarcinoma were evaluated.

Results: Adenocarcinoma caused higher prevalence of complete stenosis (14/14-100% vs 17/35-49%), dilated side-branches (14/14-100% vs 18/35-51%) and lower prevalence of duct-penetrating sign (0/14-0% vs 31/35-89%). The number of stenoses was higher in benign conditions (mean 1.4 Vs 1). Upstream MPD diameter was higher in cancer-induced stenoses (4.5 vs 2.9mm).

Conclusions: Single complete stenosis with dilated side branches, increased MPD caliber and absent duct-penetrating sign are suggestive of malignancy.

Keywords: Cancer; MRCP; Magnetic resonance imaging; Pancreas; Pancreatic stenosis; Secretin.

MeSH terms

  • Adult
  • Aged
  • Cholangiopancreatography, Magnetic Resonance / methods*
  • Constriction, Pathologic / diagnostic imaging
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Pancreatic Ducts / diagnostic imaging*
  • Pancreatic Ducts / pathology
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology
  • Reproducibility of Results
  • Retrospective Studies
  • Secretin

Substances

  • Secretin