PURPOSE: To determine the characteristic magnetic resonance imaging (MRI) features of mass-forming autoimmune pancreatitis (AIP), which allow its differentiation from pancreatic adenocarcinoma (PAC). MATERIALS AND METHODS: MR images of 37 patients with either pathologically proven, mass-forming AIPs (n = 9) or PACs (n = 28) were retrospectively reviewed. The pancreatic MR protocol included unenhanced images, contrast-enhanced dynamic images, diffusion-weighted imaging (DWI), and MR-cholangiopancreatography (MRCP). Two reviewers analyzed the MR images regarding the number, location, morphologic features, and enhancement degree and pattern of the lesions as well as secondary changes of the pancreatic parenchyma, the biliary and pancreatic ducts. The size and apparent diffusion coefficient (ADC) values of the lesions were measured. RESULTS: Although sensitivities were low (28.6%-44.4%), specificities of multiplicity, capsule-like rim enhancement, and skipped stricture of the biliary or pancreatic duct in mass-forming AIP were high (100%). Sensitivities and specificities of irregular or geographic shape, delayed enhancement, and a low ADC value <1.26 × 10(-3) mm(2) /s in mass-forming AIP were favorable (71.4%-83.3% and 78.5%-89.3%). CONCLUSION: Although to differentiate mass-forming AIP from pancreatic cancer is difficult, the combination of MRI findings including contrast-enhanced dynamic images, MRCP, and DWI can be a help.
PURPOSE: To determine the characteristic magnetic resonance imaging (MRI) features of mass-forming autoimmune pancreatitis (AIP), which allow its differentiation from pancreatic adenocarcinoma (PAC). MATERIALS AND METHODS: MR images of 37 patients with either pathologically proven, mass-forming AIPs (n = 9) or PACs (n = 28) were retrospectively reviewed. The pancreatic MR protocol included unenhanced images, contrast-enhanced dynamic images, diffusion-weighted imaging (DWI), and MR-cholangiopancreatography (MRCP). Two reviewers analyzed the MR images regarding the number, location, morphologic features, and enhancement degree and pattern of the lesions as well as secondary changes of the pancreatic parenchyma, the biliary and pancreatic ducts. The size and apparent diffusion coefficient (ADC) values of the lesions were measured. RESULTS: Although sensitivities were low (28.6%-44.4%), specificities of multiplicity, capsule-like rim enhancement, and skipped stricture of the biliary or pancreatic duct in mass-forming AIP were high (100%). Sensitivities and specificities of irregular or geographic shape, delayed enhancement, and a low ADC value <1.26 × 10(-3) mm(2) /s in mass-forming AIP were favorable (71.4%-83.3% and 78.5%-89.3%). CONCLUSION: Although to differentiate mass-forming AIP from pancreatic cancer is difficult, the combination of MRI findings including contrast-enhanced dynamic images, MRCP, and DWI can be a help.
Authors: Riccardo De Robertis; Paolo Tinazzi Martini; Emanuele Demozzi; Flavia Dal Corso; Claudio Bassi; Paolo Pederzoli; Mirko D'Onofrio Journal: World J Radiol Date: 2015-10-28
Authors: Jana Taron; Petros Martirosian; Thomas Kuestner; Nina F Schwenzer; Ahmed Othman; Jakob Weiß; Mike Notohamiprodjo; Konstantin Nikolaou; Christina Schraml Journal: Eur Radiol Date: 2017-11-13 Impact factor: 5.315
Authors: J-Matthias Löhr; Ulrich Beuers; Miroslav Vujasinovic; Domenico Alvaro; Jens Brøndum Frøkjær; Frank Buttgereit; Gabriele Capurso; Emma L Culver; Enrique de-Madaria; Emanuel Della-Torre; Sönke Detlefsen; Enrique Dominguez-Muñoz; Piotr Czubkowski; Nils Ewald; Luca Frulloni; Natalya Gubergrits; Deniz Guney Duman; Thilo Hackert; Julio Iglesias-Garcia; Nikolaos Kartalis; Andrea Laghi; Frank Lammert; Fredrik Lindgren; Alexey Okhlobystin; Grzegorz Oracz; Andrea Parniczky; Raffaella Maria Pozzi Mucelli; Vinciane Rebours; Jonas Rosendahl; Nicolas Schleinitz; Alexander Schneider; Eric Fh van Bommel; Caroline Sophie Verbeke; Marie Pierre Vullierme; Heiko Witt Journal: United European Gastroenterol J Date: 2020-06-18 Impact factor: 4.623