Evaluation of serial changes of pancreatic branch duct intraductal papillary mucinous neoplasms by follow-up with magnetic resonance imaging

被引:19
作者
Guarise, Alessandro [1 ]
Faccioli, Niccolo [1 ]
Ferrari, Mauro [1 ]
Salvia, Roberto [1 ]
Mucelli, Roberto Pozzi [1 ]
Morana, Giovanni [1 ]
Megibow, Alec J. [1 ]
机构
[1] Gen Hosp Ca Foncello, Dept Radiol, I-31100 Treviso, Italy
来源
CANCER IMAGING | 2008年 / 8卷 / 01期
关键词
Intraductal papillary mucinous neoplasm (IPMN); Magnetic resonance (MR); Pancreas;
D O I
10.1102/1470-7330.2008.0028
中图分类号
R73 [肿瘤学];
学科分类号
100214 [肿瘤学];
摘要
The purpose of this study was to clarify the biological behaviour of branch duct type intraductal papillary mucinous neoplasm (IPMN) by evaluating serial changes at magnetic resonance cholangiopancreatography (MRCP). Fifty-two patients with a diagnosis of branch duct IPMN based on either endoscopic retrograde cholangiopancreatography (ERCP) (9/52) and/or MRCP examination (43/52), were followed up over a mean period of 31.2 months (range 12-108). All imaging data were retrospectively reviewed by two radiologists in order to evaluate serial changes in the maximum diameter of the cystic lesion, in the presence of main pancreatic duct dilatation (MPD), and filling defects within the lesion. Statistical analysis was performed using the Fisher exact probability test. Serial MRCP proved growth in seven cases. In two cases the size decreased; in the remaining 43 there was no change in size. Lesions greater than 3 cm at presentation and the presence of MPD dilatation or filling defects at imaging were most likely to grow. Only 2/37 cystic lesions less than 3 cm in diameter grew in size over the period of observation. No cystic lesion showed changes in morphology and structure. Branch duct IPMNs smaller than 3 cm, without associated filling defects, tend to be stable, making 'watch and wait' management possible.
引用
收藏
页码:220 / 228
页数:9
相关论文
共 28 条
[1]
Loftus Jr. E.V., Olivares-Pakzad B.A., Batts K.P., Et al., Intraductal papillary-mucinous tumors of the pancreas: Clinicopathologic features, outcome, and nomenclature. members of the pancreas clinic, and pancreatic surgeons of mayo clinic, Gastroenterology, 110, pp. 1909-1918, (1996)
[2]
Procacci C., Graziani R., Bicego E., Bergamo-Andreis I.A., Mainardi P., Zamboni G., Pederzoli P., Cavallini G., Valdo M., Pistolesi G.F., Intraductal mucin-producing tumors of the pancreas: Imaging findings, Radiology, 198, 1, pp. 249-257, (1996)
[3]
Pilleul F., Rochette A., Partensky C., Scoazec J.-Y., Bernard P., Valette P.-J., Preoperative evaluation of intraductal papillary mucinous tumors performed by pancreatic magnetic resonance imaging and correlated with surgical and histopathologic findings, Journal of Magnetic Resonance Imaging, 21, 3, pp. 237-244, (2005)
[4]
Sahani D.V., Saokar A., Hahn P.F., Brugge W.R., Fernandez-Del C.C., Pancreatic cysts 3 cm or smaller: How aggressive should treatment be?, Radiology, 238, 3, pp. 912-919, (2006)
[5]
Takada A., Itoh S., Suzuki K., Et al., Branch duct-type intraductal papillary mucinous tumor: Diagnostic value of multiplanar reformatted images in multislice CT, Eur Radiol, 15, pp. 1888-1897, (2006)
[6]
Tanaka M., Chari S., Adsay V., Et al., International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas, Pancreatology, 6, pp. 17-32, (2006)
[7]
Longnecker D.S., Observations on the etiology and pathogenesis of intraductal papillary-mucinous neoplasms of the pancreas, Hepatogastroenterology, 45, pp. 1973-1980, (1998)
[8]
Tanaka M., Kobayashi K., Mizumoto K., Yamaguchi K., Clinical aspects of intraductal papillary mucinous neoplasm of the pancreas, J Gastroenterol, 40, pp. 669-675, (2005)
[9]
Megibow A.J., Lombardo F.P., Guarise A., Et al., Cystic pancreatic masses: Cross-sectional imaging observations and serial follow-up, Abdom Imaging, 26, pp. 640-647, (2001)
[10]
Nakagohri T., Asano T., Kenmochi T., Urashima T., Ochiai T., Long-term surgical outcome of noninvasive and minimally invasive intraductal papillary mucinous adenocarcinoma of the pancreas, World Journal of Surgery, 26, 9, pp. 1166-1169, (2002)