Duct-penetrating sign at MRCP: Usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas

T. Ichikawa, H. Sou, T. Araki, Ali Syed Arbab, T. Yoshikawa, K. Ishigame, H. Haradome, J. Hachiya

Research output: Contribution to journalArticle

165 Citations (Scopus)

Abstract

PURPOSE: To define the duct-penetrating sign at magnetic resonance (MR) cholangiopancreatography (MRCP) and to assess the usefulness of this sign for distinguishing an inflammatory pancreatic mass (IPM) from a conventional pancreatic carcinoma (CPC) compared with arterial phase computed tomography (hereafter, CT) and arterial phase MR imaging (hereafter, MR imaging). MATERIALS AND METHODS: MRCP, CT, and MR images were compared by means of receiver operating characteristic (ROC) analysis for 11 IPMs and 43 CPCs. With the MRCP images, a morphologic classification of the main pancreatic duct (MPD) was attempted for all lesions. On the basis of this classification and the enhancement patterns of a lesion, all readers graded the presence of IPM or CPC on a five-point scale for all images. RESULTS: On the MRCP images, the morphologic characteristics of the MPD were nonobstruction for IPM (28 of 33, 85%) and obstruction or irregular stenosis for CPC (124 of 129, 96%). At ROC analysis among all the techniques, MRCP images had the highest value (0.98) for significant areas under the ROC curve (CT, 0.84; MR, 0.76) (P < .001). For the duct-penetrating sign in the broad sense (nonobstructed MPD) and the sign in the narrow sense (only normal MPD), the sensitivity, specificity, and accuracy for diagnosis of IPM were 85%, 96%, and 94%, respectively, and 36%, 100%, and 87%, respectively. CONCLUSION: The duct-penetrating sign on MRCP images was more helpful to distinguish IPM from CPC than were the enhancement patterns on CT and MR images.

Original languageEnglish (US)
Pages (from-to)107-116
Number of pages10
JournalRadiology
Volume221
Issue number1
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Fingerprint

Pancreatic Ducts
ROC Curve
Magnetic Resonance Cholangiopancreatography
Magnetic Resonance Spectroscopy
Pathologic Constriction
Tomography
Magnetic Resonance Imaging
Sensitivity and Specificity
Pancreatic Carcinoma

Keywords

  • MR, 770.121411, 770.121412, 77.121415, 770.12143
  • Pancreas, CT, 770.12113, 770.12115 Pancreas
  • Pancreas, neoplasms, 774.321
  • Pancreatitis, 770.291

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Duct-penetrating sign at MRCP : Usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. / Ichikawa, T.; Sou, H.; Araki, T.; Arbab, Ali Syed; Yoshikawa, T.; Ishigame, K.; Haradome, H.; Hachiya, J.

In: Radiology, Vol. 221, No. 1, 01.01.2001, p. 107-116.

Research output: Contribution to journalArticle

Ichikawa, T, Sou, H, Araki, T, Arbab, AS, Yoshikawa, T, Ishigame, K, Haradome, H & Hachiya, J 2001, 'Duct-penetrating sign at MRCP: Usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas', Radiology, vol. 221, no. 1, pp. 107-116. https://doi.org/10.1148/radiol.2211001157
Ichikawa, T. ; Sou, H. ; Araki, T. ; Arbab, Ali Syed ; Yoshikawa, T. ; Ishigame, K. ; Haradome, H. ; Hachiya, J. / Duct-penetrating sign at MRCP : Usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas. In: Radiology. 2001 ; Vol. 221, No. 1. pp. 107-116.
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abstract = "PURPOSE: To define the duct-penetrating sign at magnetic resonance (MR) cholangiopancreatography (MRCP) and to assess the usefulness of this sign for distinguishing an inflammatory pancreatic mass (IPM) from a conventional pancreatic carcinoma (CPC) compared with arterial phase computed tomography (hereafter, CT) and arterial phase MR imaging (hereafter, MR imaging). MATERIALS AND METHODS: MRCP, CT, and MR images were compared by means of receiver operating characteristic (ROC) analysis for 11 IPMs and 43 CPCs. With the MRCP images, a morphologic classification of the main pancreatic duct (MPD) was attempted for all lesions. On the basis of this classification and the enhancement patterns of a lesion, all readers graded the presence of IPM or CPC on a five-point scale for all images. RESULTS: On the MRCP images, the morphologic characteristics of the MPD were nonobstruction for IPM (28 of 33, 85{\%}) and obstruction or irregular stenosis for CPC (124 of 129, 96{\%}). At ROC analysis among all the techniques, MRCP images had the highest value (0.98) for significant areas under the ROC curve (CT, 0.84; MR, 0.76) (P < .001). For the duct-penetrating sign in the broad sense (nonobstructed MPD) and the sign in the narrow sense (only normal MPD), the sensitivity, specificity, and accuracy for diagnosis of IPM were 85{\%}, 96{\%}, and 94{\%}, respectively, and 36{\%}, 100{\%}, and 87{\%}, respectively. CONCLUSION: The duct-penetrating sign on MRCP images was more helpful to distinguish IPM from CPC than were the enhancement patterns on CT and MR images.",
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T1 - Duct-penetrating sign at MRCP

T2 - Usefulness for differentiating inflammatory pancreatic mass from pancreatic carcinomas

AU - Ichikawa, T.

AU - Sou, H.

AU - Araki, T.

AU - Arbab, Ali Syed

AU - Yoshikawa, T.

AU - Ishigame, K.

AU - Haradome, H.

AU - Hachiya, J.

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N2 - PURPOSE: To define the duct-penetrating sign at magnetic resonance (MR) cholangiopancreatography (MRCP) and to assess the usefulness of this sign for distinguishing an inflammatory pancreatic mass (IPM) from a conventional pancreatic carcinoma (CPC) compared with arterial phase computed tomography (hereafter, CT) and arterial phase MR imaging (hereafter, MR imaging). MATERIALS AND METHODS: MRCP, CT, and MR images were compared by means of receiver operating characteristic (ROC) analysis for 11 IPMs and 43 CPCs. With the MRCP images, a morphologic classification of the main pancreatic duct (MPD) was attempted for all lesions. On the basis of this classification and the enhancement patterns of a lesion, all readers graded the presence of IPM or CPC on a five-point scale for all images. RESULTS: On the MRCP images, the morphologic characteristics of the MPD were nonobstruction for IPM (28 of 33, 85%) and obstruction or irregular stenosis for CPC (124 of 129, 96%). At ROC analysis among all the techniques, MRCP images had the highest value (0.98) for significant areas under the ROC curve (CT, 0.84; MR, 0.76) (P < .001). For the duct-penetrating sign in the broad sense (nonobstructed MPD) and the sign in the narrow sense (only normal MPD), the sensitivity, specificity, and accuracy for diagnosis of IPM were 85%, 96%, and 94%, respectively, and 36%, 100%, and 87%, respectively. CONCLUSION: The duct-penetrating sign on MRCP images was more helpful to distinguish IPM from CPC than were the enhancement patterns on CT and MR images.

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KW - Pancreas, neoplasms, 774.321

KW - Pancreatitis, 770.291

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