Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP
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Enrico Boninsegna1, Riccardo Manfredi1, Riccardo Negrelli1
1Department of Radiology, Policlinico G.B. Rossi, University of Verona, Italy.
Purpose:
To define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis.
Materials-Methods:
S-MRCPs of 35 patients with pancreatitis and 14 with adenocarcinoma were evaluated.
Results:
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).
Conclusions:
Single complete stenosis with dilated side branches, increased MPD caliber and absent duct-penetrating sign are suggestive of malignancy.
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