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

• DOI: 10.1016/j.clinimag.2016.10.020
• Publication Date: 2016-10-29T00:30:29Z
• Authors: Enrico Boninsegna; Riccardo Manfredi; Riccardo Negrelli; Giacomo Avesani; Sara Mehrabi; Roberto Pozzi Muc...
• Keywords: Adult; Male; Cholangiopancreatography, Magnetic Resonance; Pancreatic Ducts; Reproducibility of Results; Constriction, Pathologic; Middle Aged; Image Enhancement; 3. Good health; Diagnosis, Differential; Pancreatic Neoplasms; 03 medical and health sciences; 0302 clinical medicine; Secretin; Humans; Female; Cancer; MRCP; Magnetic resonance imaging; Pancreas; Pancreatic stenosis; Secretin; Aged; Retrospective Studies

To define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis.S-MRCPs of 35 patients with pancreatitis and 14 with adenocarcinoma were evaluated.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).Single complete stenosis with dilated side branches, increased MPD caliber and absent duct-penetrating sign are suggestive of malignancy.