Differential Diagnosis of IgG4-related Pancreatitis and Pancreatic Cancer by MRI Features and Its Correlation with Serum IgG4 Level.

Abstract

It was to analyze the diagnostic value of MRI in immunoglobulin G (IgG4)-related autoimmune pancreatitis (AIP) and pancreatic cancer (PC) and its relationship with serum IgG4 level. 35 patients with IgG4-related AIP (group A1) and 50 patients with PC (group A2) were enrolled. MRI was performed to determine serum IgG4 levels. Spearsman was used to analyze the relationship between MRI characteristics and serum IgG4 level. It was found that patients in group A1 showed double duct sign (DDS), pancreatic duct (PD) perforation sign, the proportion of main PD truncation, and main PD diameter/pancreatic parenchymal width ratio, which were different from those of patients in group A2 (P < 0.05). MRI had a sensitivity (Sen) of 88%, specificity (Spe) of 91.43%, accuracy (Acc) of 89.41%, positive predictive value (PPV) of 0.936, and negative predictive value(NPV) of 0.842 for the diagnosis of IgG4-related AIP and PC. Serum IgG4 levels were significantly negatively correlated with DDS and main PD truncation, significantly positively correlated with PD penetration sign, and extremely significantly negatively correlated with main PD diameter/pancreatic parenchymal width (P < 0.001). The results showed that MRI had high sensitivity and specificity for differentiating IgG4-related AIP from PC, and the diagnostic effect was good, which had a high correlation with serum IgG4 levels in patients.