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Pancreas divisum: depiction with multi-detector row CT
Jorge A Soto1, Brian C Lucey, Joshua W Stuhlfaut
1Department of Radiology, Boston University Medical Center, One Boston Medical Center Place, Boston, MA 02118, USA. jorge.soto@bmc.org
Radiology
|March 17, 2005
Summary
Multi-detector row computed tomography (CT) effectively depicts pancreas divisum when the pancreatic duct is visualized. This imaging technique shows high accuracy in diagnosing this congenital anomaly.
Area of Science:
- Radiology
- Gastroenterology
- Anatomical Imaging
Background:
- Pancreas divisum is a congenital anomaly resulting from the failure of fusion of the dorsal and ventral pancreatic ducts.
- Accurate diagnosis is crucial for appropriate management and understanding of associated pancreatic pathologies.
Purpose of the Study:
- To evaluate the effectiveness of contrast-enhanced multi-detector row computed tomography (CT) in visualizing and diagnosing pancreas divisum.
- To assess the diagnostic performance of CT compared to endoscopic retrograde pancreatography (ERP).
Main Methods:
- Retrospective analysis of 77 patients who underwent multi-detector row CT and ERP.
- CT images were reviewed by two independent radiologists blinded to clinical and ERP data.
- Pancreas divisum diagnosis at CT was based on the "dominant dorsal duct sign" and lack of communication between dorsal and ventral ducts.
Main Results:
- CT visualization of the pancreatic duct was sufficient in 95% of patients.
- Sensitivity for detecting pancreas divisum was 90% and specificity was 97-98% for the two readers.
- Excellent interobserver agreement (kappa = 0.93) was observed.
Conclusions:
- Contrast-enhanced multi-detector row CT is a valuable tool for depicting pancreas divisum.
- Adequate visualization of the pancreatic duct is essential for accurate CT diagnosis.