Abstract
Objective To quantitatively analyze pancreaticobiliary duct changes by magnetic resonance imaging (MRI) and assess its value in the differential diagnosis of pancreatic duct adenocacinoma (PDAC) and other periampullary carcinomas. Methods Eighty-one patients who had histopathologically confirmed periampullary carcinomas and underwent MRI were enrolled, including 41 with PDACs, 20 with intrapancreatic common bile duct (CBD) carcinomas, and 20 with ampullary carcinomas. The sum of the maximum diameters of the CBD and main pancreatic duct (MPD), the distance between the ends of the dilated pancreaticobiliary duct, and the distance between the major papilla and the end of the dilated pancreaticobiliary duct were calculated as summation of the distances. The pancreaticobiliary duct angle was measured by MRI. SPSS18.0 software was used for statistical analyses. The cut-off values for pancreaticobiliary duct angles and summation of the distance were confirmed using receiver operating characteristic curve. Results The pancreaticobiliary duct angle in PDAC (86.2°±13.8°) was greater than that in other malignancies (61.6°±10.7°). The summation of the distances in PDAC (9.3±1.7 cm) was greater than that in others (7.8±1.2 cm). A sequential test for the average pancreaticobiliary duct angle and summation of the distances suggested 70° and 9 cm as cut-off values, respectively. The sensitivity and specificity were 67% and 96%, respectively. The AUC of the sequential test was 0.93. Conclusion PDAC can be differentiated from other types of periampullary carcinoma by the quantitative analysis of pancreaticobiliary ductal changes with a high sensitivity and specificity. The combination of pancreaticobiliary duct angle and the summation of the distances increases the diagnostic accuracy. Key words: Pancreaticobiliary duct; Periampullary carcinoma; Differential diagnosis; Magnetic resonance imaging
Published Version
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