Assessment of Malignancy Potential in Intraductal Papillary Mucinous Neoplasms of the Pancreas on MDCT.
Acad Radiol
; 28(5): 679-686, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-32591278
ABSTRACT
RATIONALE AND OBJECTIVE:
To assess the malignancy potential of intraduct papillary mucinous neoplasms (IPMNs) on multidetector-row computerized tomography according to the 2012 International Consensus Guidelines (ICG). MATERIALS ANDMETHODS:
This study retrospectively collected IPMNs confirmed by surgery from 2016 to 2019. The imaging findings of IPMNs were analyzed. IPMNs were classified as malignancy in the presence of high-grade dysplasia or invasive carcinoma and began in the presence of low- and intermediate-grade dysplasia.RESULTS:
A total of 207 patients (mean age 63.7 ± 7.9 years) were included, and the prevalence of malignancy was 28.0% (58 of 207). According to the 2012 ICG, the imaging findings of IPMNs were divided into worrisome features (WFs) and high-risk stigmata (HRS). The malignancy of IPMN with only one WF was relatively low (1.4%, 3 of 207). In multivariate regression analyses, the independent factors of IPMNs were enhanced mural nodule ≥5 mm (odds ratio [OR]â¯=â¯19.5, 95% confidence interval [CI] 6.8-55.4), abrupt change in the main pancreatic duct caliber with distal pancreatic atrophy (ORâ¯=â¯4.6, 95%CI 1.67-12.71), and thickened enhanced cyst walls (ORâ¯=â¯2.9, 95%CI 1.1-8.2). When the presence of more than two WFs or HRS (score ≥ 3) was regarded as indicating the malignancy potential of IPMNs on multidetector-row computerized tomography, the sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were 89.7%, 75.8%, 79.7%, 59.1%, and 95.0%, respectively.CONCLUSION:
According to the ICG in 2012, patients with IPMNs with only one WF have a low risk for malignancy, and the presence of at least two WFs or any HRS (score ≥3) suggests malignant IPMNs.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
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Carcinoma Ductal Pancreático
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Neoplasias Intraductais Pancreáticas
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article