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Focal pancreatic mass: distinction of pancreatic cancer from chronic pancreatitis using gadolinium-enhanced 3D-gradient-echo MRI.

Authors
Kim, JK; Altun, E; Elias, J Jr; Pamuklar, E; Rivero, H; Semelka, RC
Citation
Journal of magnetic resonance imaging : JMRI, 26(2):313-322, 2007
Journal Title
Journal of magnetic resonance imaging : JMRI
ISSN
1053-18071522-2586
Abstract
PURPOSE: To determine the accuracy of MRI including T1-weighted gadolinium (Gd)-enhanced three-dimensional-gradient-echo (3D-GE) sequences to distinguish pancreatic cancer from chronic pancreatitis in patients with pancreatic mass or focal enlargement.



MATERIALS AND METHODS: The study included 22 patients (15 males and seven females; mean age +/- SD, 56.2 +/- 11.5 years) with pancreatic mass or focal enlargement. Fourteen had pancreatic carcinoma and eight had chronic pancreatitis based on the histopathological and clinical findings. MRI examinations of all patients were retrospectively evaluated by two independent reviewers for the predetermined imaging findings of carcinoma and chronic pancreatitis. The accuracy of MRI for differentiating pancreatic carcinoma from chronic pancreatitis was determined. MRI findings of both entities were compared using t-tests, chi-squared tests, and logistic regression analyses for the differentiation of these two entities. The extent of agreement between two reviewers was determined with Kappa statistics.



RESULTS: The sensitivity and specificity of MRI including T1-weighted 3D-GE sequences for differentiating pancreatic carcinoma from chronic pancreatitis were 93% (13/14) and 75% (6/8), respectively. The most discriminative finding for pancreatic carcinoma was relative demarcation of the mass compared to background pancreas in contrast to chronic pancreatitis on post-Gd 3D-GRE sequences (P < 0.05).



CONCLUSION: MRI including Gd-enhanced T1-weighted 3D-GE sequences can differentiate pancreatic carcinoma from chronic pancreatitis successfully in most cases.
MeSH terms
AgedCarcinoma/metabolismDiagnosis, DifferentialFemaleGadolinium/pharmacology*HumansImaging, Three-Dimensional/methodsInflammationMagnetic Resonance Imaging/methods*MaleMiddle AgedPancreas/pathologyPancreatic Neoplasms/diagnosis*Pancreatic Neoplasms/pathologyPancreatitis/diagnosis*Pancreatitis/pathologySensitivity and Specificity
DOI
10.1002/jmri.21010
PMID
17610286
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
AJOU Authors
김, 재근
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