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

2016; Elsevier BV; Volume: 41; Linguagem: Inglês

10.1016/j.clinimag.2016.10.020

1873-4499

Enrico Boninsegna, Riccardo Manfredi, Riccardo Negrelli, Giacomo Avesani, Sara Mehrabi, Roberto Pozzi Mucelli,

Pediatric Hepatobiliary Diseases and Treatments

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.