Mucinous cystic neoplasms of the pancreas: high-resolution cross-sectional imaging features with clinico-pathologic correlation.
Abdom Radiol (NY)
; 43(6): 1413-1422, 2018 06.
Article
em En
| MEDLINE
| ID: mdl-28936758
ABSTRACT
PURPOSE:
To describe the high-resolution cross-sectional (MDCT/MRI) features of mucinous cystic neoplasms (MCN) of the pancreas with clinico-pathologic correlation; to identify imaging predictors of high-grade dysplasia/carcinoma; and to estimate MCN growth rate. MATERIALS ANDMETHODS:
Thirty-two women (mean age 46; range, 25-79 years) with resected MCN who underwent preoperative MDCT (n = 20) or MRI (n = 12) examinations over a 14-year period were included. Two radiologists examined retrospectively in consensus the following MDCT/MRI features MCN location, size/volume, presence of capsule and thickness of the capsule, and presence of mural nodules, enhancing septations, calcifications, chronic pancreatitis, and main pancreatic duct dilation. Imaging features were correlated with clinical symptoms, biochemistry results, and histopathologic features. A univariate model was analyzed for the prediction of high-grade dysplasia/carcinoma. Preoperative MCN growth rate was assessed using a subset of patients with more than one imaging study available (n = 6).RESULTS:
Twenty-five (78%) patients presented with symptoms and 8 (25%) patients had abnormal serum biochemical values. Mean MCN maximum dimensions were 48 × 45 × 45 mm with a mean volume of 169 mL. MCN were located in the tail (n = 18), body (n = 10), neck (n = 2), and (head = 2); 30 (93.5%) MCN were encapsulated, 3 (9%) had calcifications, 4 (12%) showed enhancing nodules, 9 (28%) had enhancing septations, and 5 (15%) had main pancreatic duct dilation. Associated chronic pancreatitis was observed in 4 (12%) patients. The only predictors for high-grade dysplasia/carcinoma were MCN size and volume. Using a cut-off size greater than 8.5 cm, the specificity and sensitivity for high-grade dysplasia/carcinoma were 97 and 60%, respectively (p = 0.003; OR 81, 95% CI 3.9-1655.8). Mean MCN growth rate was estimated at 4.2 mm/year with a doubling time of 8.23 years.CONCLUSION:
MCN size (> 8.5 cm) and volume are the only features on MDCT/MR imaging that correlate with high-grade dysplasia/carcinoma. The average growth rate for MCNs is slow at approximately 4 mm per year.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
/
Imageamento por Ressonância Magnética
/
Tomografia Computadorizada por Raios X
/
Neoplasias Císticas, Mucinosas e Serosas
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Abdom Radiol (NY)
Ano de publicação:
2018
Tipo de documento:
Article