Mucinous Cystadenomas and Intraductal Papillary Mucinous Tumors of the Pancreas in Magnetic Resonance Cholangiopancreatography

Albért, J; Schilling, Dieter; Breer, H; Jungius, Karl-Peter; Riemann, J. F.; Adamek, Henning E.

doi:10.1055/s-2000-646

Cited by 44 publications

(24 citation statements)

References 13 publications

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“…The presence of intracystic mural nodules >3 mm in size on CT also suggests malignancy (39)(40)(41). MRP is more sensitive than ERCP in differentiating mural nodules from mucin globules (40)(41)(42)(43)(44). It also consistently demonstrates the internal architecture of the main duct and the extent of IPMN better than ERP.…”

Section: Imaging (Level 2-3)mentioning

confidence: 82%

ACG Practice Guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts

Khalid¹,

Brugge²

2007

Am J Gastroenterology

290

197

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The diagnosis and management of pancreatic cystic lesions is a common problem. At least 1% of hospitalized patients at major medical centers will have a pancreatic cystic lesion on cross sectional imaging. Up to a quarter of all pancreata examined in an autopsy series contained a pancreatic cyst, 16% of which were lined by an "atypical" epithelium and 3% of which had progressed to carcinoma-in-situ (high grade dysplasia). in the past, it was thought these cystic lesions were benign, but increasing evidence points to the cystic lesions as being the origin of some pancreatic malignancies.The most important clinical tools in the diagnosis and management of pancreatic cystic lesions are cross sectional imaging, endoscopic ultrasound, and cyst fluid analysis. The most important differential diagnosis is distinguishing mucinous (pre-malignant) and non-mucinous cystic lesions. The findings of a macrocystic lesion containing viscous fluid rich in CEA are supportive of a diagnosis of a mucinous lesion. Serous lesion are the most common non-mucinous cyst and are characterized by a microcystic morphology, non-viscous fluid and a low concentration of CEA in the cyst fluid.The following document includes a description of neoplastic pancreatic cysts, a critical review of relevant diagnostic tests, and a discussion of treatment options. We have proposed a set of guidelines for the diagnonis and management of patients with neoplastic pancreatic cysts. The guidelines are based on published data backed by an analysis of the quality of the data and are designed to address the most frequent and important clinical scenarios. In addition to providing a summary of the diagnostic data, we offer diagnostic and management suggestions based on 13 common clinical problems. Although the field is rapidly evolving, a set of core principles is provided based on a balance between the risk of malignancy and the benefit of pancreatic resection.

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Section: Imaging (Level 2-3)mentioning

confidence: 82%

ACG Practice Guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts

Khalid¹,

Brugge²

2007

Am J Gastroenterology

290

197

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“…Due to the potential complications of this procedure and since up to 80% of mucinous cystadenomas do not involve the main pancreatic duct, endoscopic retrograde pancreatography was not performed in our patients [16]. Preliminary studies report that magnetic resonance pancreatography might be helpful in the preoperative diagnosis of pancreatic cystic lesions, but these results must be confirmed [17].…”

Section: Discussionmentioning

confidence: 99%

Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas

et al. 2002

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“…One differentiates between intraductal papillary mucinous tumors (IPMTs), starting at the main duct of the pancreas and mucinous cystadenomas originating in the peripheral duct system [48,49]. The diagnosis of intraductal papillary tumors is the domain of ERCP, however, the first data available indicate a comparable diagnostic potential for MRCP [50][51][52][53] (table 5). ERCP allows for the possibility of inspecting the papilla with the characteristic image of a wide papilla with mucus discharged from the pancreatic duct in 27-84% [54].…”

Section: Epithelial Cystic Tumors Of Exocrine Pancreasmentioning

confidence: 99%

ERCP and MRCP in the Differentiation of Pancreatic Tumors

Hartmann

Schilling²,

Bassler³

et al. 2004

Dig Dis

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The introduction of endoscopic retrograde cholangiopancreatography (ERCP) in the early 1970s provided gastroenterologists with a number of diagnostic as well as therapeutic possibilities for examining biliopancreatic systems. In the meantime, magnetic resonance cholangiopancreatography presents a non-invasive alternative to diagnostic ECRP providing the advantage of a lower rate of possible complications. This article addresses the two methods presently available for differentiating pancreatic tumors. The objective of this article is to describe the advantages and disadvantages as well as the possibilities inherent in both methods.

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Mucinous Cystadenomas and Intraductal Papillary Mucinous Tumors of the Pancreas in Magnetic Resonance Cholangiopancreatography

Abstract: MRCP provides visualization of pancreatic ducts, extraductal variations, and cystic formations more completely than ERCP does. It avoids complications seen in ERCP. MRCP may replace ERCP in the evaluation of mucin-producing tumors of the pancreas.

Cited by 44 publications

References 13 publications

ACG Practice Guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts

ACG Practice Guidelines for the Diagnosis and Management of Neoplastic Pancreatic Cysts

Benign inflammatory pancreatic mucinous cystadenomas mimicking locally advanced cystadenocarcinomas

ERCP and MRCP in the Differentiation of Pancreatic Tumors

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