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Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP
No full textTo define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis
MRI features of solid pseudopapillary neoplasm of the pancreas
No full textPURPOSE:
To evaluate the magnetic resonance imaging (MRI) findings of solid pseudopapillary neoplasm (SPN) of the pancreas.
METHODS AND MATERIALS:
From January 2006 to December 2013, 41 patients with SPN of the pancreas were retrospectively evaluated. Inclusion criteria were the execution of an MR examination and tumor resection with an histopathological evaluation at our Institute. Exclusion criteria were the execution of an MR examination at other centers (14/41) and the execution of CT or ultrasonography (10/41) at our Institute. The qualitative analysis evaluated: location (head/body-tail), shape (round/oval/lobulated), margins (regular/irregular), and signal intensity on T1- and T2-weighted images compared to the surrounding pancreas (hypo-, iso-, or hyperintense and homogeneous or heterogeneous), appearance of MPD and the secondary ducts, and the presence of metastases and/or vascular involvement. The quantitative analysis included: maximum size of the lesion, wall thickness, and maximum diameter of the main pancreatic duct (MPD).
RESULTS:
The population comprised 17 women (median age: 31 year) with a median tumor size of 50.6 mm, a median wall thickness of 2 mm and median diameter of the MPD of 1.8 mm. 9/17 were at the head; 8/17 on the body/tail: respectively, 8/17 round, 6/17 oval, and 3/17 lobulated. All showed regular margins. On T1-weighted images 8/17 appeared homogeneously hypointense, 7/17 heterogeneously hypointense, and 2/17 heterogeneously hyperintense. On T2-weighted images 1/17 appeared homogeneously hyperintense and 16/17 heterogeneously hyperintense. No secondary ducts dilatations were detected. During the follow-up, one patient presented disease recurrence 48 months after surgery.
CONCLUSIONS:
MR imaging features can be highly suggestive for the diagnosis of SPN
Detection and localization of deep endometriosis by means of MRI and correlation with the ENZIAN score
No full textTo determine the accuracy of ENZIAN score, as detected on MR imaging, compared to surgical-pathologic findings.This retrospective study was approved by the investigational review board and the requirement for informed patient consent was waived. 115 patients were included according to following criteria: tubo-ovarian and/or deep endometriosis suspected at physical examination and transvaginal ultrasound; availability of MR examination; histopathological results from laparoscopic or surgical treatment. Exclusion criteria: lack of available MR examination, and/or (b) lack of a definitive histopathological results. Histopathological findings from bioptic specimens obtained during laparoscopic or laparotomic treatment were considered as reference standard. For all detected lesions a score according to ENZIAN score (revised 2010) was assigned both for MRI and histopathological findings. By comparing MRI-ENZIAN score and histopathological-ENZIAN score the overall sensitivity, specificity, accuracy, positive and negative predictive values in relation to presence/absence of deep endometriosis in each patient were calculated. k-Cohen to evaluate the degree of concordance between MRI-ENZIAN score and histopathological-ENZIAN score was also measured. Moreover the sensitivity, specificity, accuracy, positive and negative predictive values for each specific localization provided by ENZIAN score were also calculated.At histopathology, the diagnosis of deep endometriosis was confirmed in 82/115 (71.3\%) patients. The sensitivity, specificity, accuracy, PPV and NPV of MRI were 94\%, 97\%, 95\%, 99\%, 86\%, respectively. The highest accuracy was for adenomyosis (100\%) and endometriosis of utero-sacral ligaments (USLs) (98\%), slightly lower for vagina-rectovaginal septum an colo-rectal walls (96\%), and the lowest for bladder endometriosis (92\%). The concordance between histopathological and MRI ENZIAN score was excellent (k=0.824); in particular it was 0.812 for lesions in vagina-rectovaginal space, 0.890 for lesions in USL, 0.822 for lesions in rectum-sigmoid colon, 1.000 for uterine adenomyosis, and 0.367 for lesions located in the bladder wall.MRI correlates with the ENZIAN score and has an accuracy of 95\% in the detection and localization of deep endometriosis, allowing to minimize false negative results (4\%) in patients with deep endometriosis and to obtain a correct preoperative staging
MRI-MRCP findings in focal and diffuse autoimmune pancreatitis and comparison of focal type of the head and of the body-tail
No full textPoster B-000
Secretin-enhanced MRCP findings in patients with pancreatic duct stenosis: signs of benignity and malignancy
No full textno availabl
Utility of DWI sequences in autoimmune pancreatitis before and after steroid therapy
No full textNo availabl
Focal and diffuse autoimmune pancreatitis: MRI-MRCP findings and comparison of focal-type of the head and of the body-tail
No full textno availabl
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