Distinguishing Benign From Malignant Main Duct Intraductal Papillary Mucinous Of The Pancreas By MSCT

Part 1 Distinguishing benign from malignant main duct intraductal papillary mucinous tumors of the pancreas by imaging features of main ductObjective: To evaluate the imaging features of main duct in differentiating maligment from benign main duct intraductal papillary mucinous neoplasms(MD-IPMNs).Methods: The imaging studies of a tatal of 66 patients with MD-IPMNs which have confirmed by pathology after sugery was retrospectively reviewed.All patients underwent MSCT.Two radiologists observed and recorded the lesions of main duct’ s imaging features.The diameter and dilation shape of main duct was compared with the pathological results.Finally,a ROC curve was used to calculate AUC,and to evaluate the role of the maximum diameter of the main duct obtained by imaging studies in differentiation of maligment and benign MD-IPMNs,and to determine the best cut-off point,and sensitivity,sepesificity.Results: The maximum diameter of the main duct was clinically meaningful for distinguishing malignant from benign lesions,and the AUC was 75.9%,and the best cut-off vaule was 11 mm,the sensitivity and specificity was 73.9% and 85.5%.Irregular dilation shape of main duct could be an imaging features for distinguishing malignant from benign lesions.Conclusion: The imaging features of the main duct are sensitive for differentiation between maligment and benign MD-IPMNs,and it is of clinical value for preoperative evaluation and follow up.Part 2 Distinguishing benign from malignant main duct intraductal papillary mucinous tumors of the pancreas by imaging features of mural noduleObjective: To evaluate the imaging features of mural nodule in differentiating maligment from benign main duct intraductal papillary mucinous neoplasms(MD-IPMNs).Methods: The imaging studies of a tatal of 41 patients with MD-IPMNs which have definite mural nodules confirmed by MSCT and pathology after sugery was retrospectively reviewed.All patients underwent MSCT.Two radiologists observed and recorded the lesions of mural nodules’ imaging features.The size,location,amount,margin and enhancement of the mural nodules was compared with the pathological results.Finally,a ROC curve was used to calculate AUC,and to evaluate the role of the maximum diameter of the mural nodules obtained by imaging studies in differentiation of maligment and benign MD-IPMNs,and to determine the best cut-off point,and sensitivity,sepesificity.Results: The maximum diameter of the size of the mural nodule was clinically meaningful for distinguishing malignant from benign lesions,and the AUC was 74.7%,and the best cut-off vaule was 1.35 cm,the sensitivity and specificity was 56% and 91.7%.Multiple mural nodules and illdefined margins could be an imaging features for distinguishing malignant from benign lesions,but location and enhancement of mural nodules was not useful for differentiation.Conclusions: The imaging features of the mural nodules are sensitive for differentiation between maligment and benign MD-IPMNs,and it is of clinical value for preoperative evaluation and follow up.Part 3 Distinguishing benign from malignant main duct intraductal papillary mucinous tumors of the pancreas by other imaging featuresObjective: To evaluate the imaging features of pancreatic atrophy,calcification,obstructive jaundice in differentiating maligment from benign main duct intraductal papillary mucinous neoplasms(MD-IPMNs).Methods: The imaging studies of a tatal of 66 patients with MD-IPMNs which have confirmed by pathology after sugery was retrospectively reviewed.All patients underwent MSCT.Two radiologists observed and recorded the lesions of pancreatic atrophy,calcification,obstructive jaundice and compared with the pathological results.Evaluating the importance of above imaging features in distinguishing benign from malignant main duct intraductal papillary mucinous tumors.Results: Imaging features of pancreatic atrophy,calcification,obstructive jaundice were more frequently seen in malignant cases(P<0.05=.Conclusions: The imaging features of the pancreatic atrophy,calcification,obstructive jaundice are sensitive for differentiation between maligment and benign MD-IPMNs,and it is of clinical value for preoperative evaluation and follow up.