Document Detail

Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience.
MedLine Citation:
PMID:  23211370     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP.
METHODS: For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging.
RESULTS: The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P < 0.001 for each). On review by expert radiologists, the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (κ = 0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (κ = 0.43).
CONCLUSIONS: Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.
Vladimir M Kushnir; Sachin B Wani; Kathryn Fowler; Christine Menias; Rakesh Varma; Vamsi Narra; Christine Hovis; Faris M Murad; Daniel K Mullady; Sreenivasa S Jonnalagadda; Dayna S Early; Steven A Edmundowicz; Riad R Azar
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pancreas     Volume:  42     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-08-30     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  436-41     Citation Subset:  IM    
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MeSH Terms
Biliary Tract Diseases / diagnosis,  radiography,  ultrasonography
Cholangiopancreatography, Endoscopic Retrograde / methods
Cholangiopancreatography, Magnetic Resonance / methods*
Diagnosis, Differential
Endosonography / methods*
Middle Aged
Multidetector Computed Tomography / methods*
Pancreas / abnormalities,  radiography*,  ultrasonography*
Pancreatic Diseases / diagnosis,  radiography,  ultrasonography
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Tertiary Care Centers
Grant Support
Comment In:
Pancreas. 2014 Jan;43(1):141-53   [PMID:  24326368 ]

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