Document Detail


Management of branch-duct intraductal papillary mucinous neoplasms of the pancreas: observation with MR imaging.
MedLine Citation:
PMID:  20833500     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: To evaluate the clinical outcomes of conservative management by observation with MRI of patients with branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs).
MATERIALS AND METHODS: Twenty-three consecutive patients, who were followed up by MRI with magnetic resonance cholangiopancreatography (MRCP) over a period of more than 9 months after initial MRI examinations, were enrolled in this study. On MRI, number of lesions, the maximum diameter of BD-IPMNs, lesion location, the presence of associated dilatation of main pancreatic duct (MPD), the presence of enhancing mural nodules within the lesion and the presence of interval change were retrospectively reviewed on initial and follow-up MR images in consensus by two radiologists. All patients were evaluated to search for evidence of malignant progression of disease.
RESULTS: The follow-up period ranged from 10 to 96 months (mean, 37 months). On initial MRI with MRCP, a total of 39 lesions were found in 23 patients. The maximum diameter of BD-IPMNs ranged between 6 and 32 mm, with a mean of 12 mm. Thirty-four lesions (87%) of 19 patients remained unchanged in the maximum diameter. Five lesions (13%) of four patients showed an increase in the maximum diameter. Enhancing mural nodules were not found in any individual, neither on the initial MRI study nor on the follow-up studies. There was no patient who had evidence of local aggressive growth of tumor or evidence of metastases to distant sites.
CONCLUSION: Our study suggests that branch-duct IPMNs without enhancing mural nodules are essentially benign and should be managed nonoperatively through observation by MRI.
Authors:
Sang Soo Shin; Diane M Armao; Monty Shah; Young Hoon Kim; Chang Hee Lee; Tara Rubinas; Lauren M Brubaker; Richard C Semelka
Publication Detail:
Type:  Journal Article     Date:  2010-09-15
Journal Detail:
Title:  Magnetic resonance imaging     Volume:  28     ISSN:  1873-5894     ISO Abbreviation:  Magn Reson Imaging     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214883     Medline TA:  Magn Reson Imaging     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1440-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7510, USA.
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