PURPOSE: To estimate the prevalence of pancreatic cysts (PCs) in a population of patients addressed to Magnetic Resonance Cholangiopancreatography (MRCP) for disease unrelated to the pancreas, and to analyze it with respect to clinical and imaging features. MATERIALS AND METODHS: MRCPs performed over a 2-years period on 156 patients with unsuspected/unknown pancreatic disease were retrospectively reviewed to assess: PCs presence, number, size, location (head/body/tail), relation with the main pancreatic duct (close vs. far; communicating vs. non communicating), and evolution in patients who underwent follow-up examinations. Multiple logistic regression analysis was performed to evaluate the correlation of PCs with clinical information (age, sex, history of neoplasm or autoimmune biliary disease, presence of hepatic and/or renal cysts) and type of pancreaticobiliary findings at MRCP. RESULTS: Prevalence of PCs was 43.6%. Cysts ranged in size from 3.0 to 53 mm (mean, 6.7 mm), and were equal or less than 3 in number in 79.4% of patients. Based on number, dimensions and relation with the main pancreatic duct, PCs were arranged in an intraductal-papillary-mucinous tumor (IPMT)-like pattern in 30.8% of patients. During the follow-up on 20 patients no evolution of PCs was found, except for one case with proven IPMT showing increase in cysts number and dimensions. Features correlating with PCs at the multivariate analysis (p<0.01) were age ≥60 years-old, and history of autoimmune biliary disease, showing odds ratios of 4.78 (95%C.I. 2.31-9.91) and 0.18 (95%C.I. 0.05-0.60), respectively. CONCLUSIONS: PCs represent a frequent incidental finding at MRCP, correlating positively with increasing age, and negatively with biliary autoimmune disease. An IPMT-like pattern was present in approximately one-third of patients with cysts. CLINICAL RELEVANCE: High prevalence of incidental PCs using MRCP is challenging, due to the uncertainty about pathogenesis, biologic behaviour, and management of these lesions, especially of the small ones.

Incidental pancreatic cysts on 3D Turbo Spin Echo Magnetic Resonance Cholangiopancreatography: Prevalence, and relation with, Clinical and Imaging features.

GIROMETTI, Rossano;Cereser L;ZUIANI, Chiara
2009-01-01

Abstract

PURPOSE: To estimate the prevalence of pancreatic cysts (PCs) in a population of patients addressed to Magnetic Resonance Cholangiopancreatography (MRCP) for disease unrelated to the pancreas, and to analyze it with respect to clinical and imaging features. MATERIALS AND METODHS: MRCPs performed over a 2-years period on 156 patients with unsuspected/unknown pancreatic disease were retrospectively reviewed to assess: PCs presence, number, size, location (head/body/tail), relation with the main pancreatic duct (close vs. far; communicating vs. non communicating), and evolution in patients who underwent follow-up examinations. Multiple logistic regression analysis was performed to evaluate the correlation of PCs with clinical information (age, sex, history of neoplasm or autoimmune biliary disease, presence of hepatic and/or renal cysts) and type of pancreaticobiliary findings at MRCP. RESULTS: Prevalence of PCs was 43.6%. Cysts ranged in size from 3.0 to 53 mm (mean, 6.7 mm), and were equal or less than 3 in number in 79.4% of patients. Based on number, dimensions and relation with the main pancreatic duct, PCs were arranged in an intraductal-papillary-mucinous tumor (IPMT)-like pattern in 30.8% of patients. During the follow-up on 20 patients no evolution of PCs was found, except for one case with proven IPMT showing increase in cysts number and dimensions. Features correlating with PCs at the multivariate analysis (p<0.01) were age ≥60 years-old, and history of autoimmune biliary disease, showing odds ratios of 4.78 (95%C.I. 2.31-9.91) and 0.18 (95%C.I. 0.05-0.60), respectively. CONCLUSIONS: PCs represent a frequent incidental finding at MRCP, correlating positively with increasing age, and negatively with biliary autoimmune disease. An IPMT-like pattern was present in approximately one-third of patients with cysts. CLINICAL RELEVANCE: High prevalence of incidental PCs using MRCP is challenging, due to the uncertainty about pathogenesis, biologic behaviour, and management of these lesions, especially of the small ones.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11390/881660
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