The Role of Ct Scan in the Diagnosis of Pancreatic Cystic Lesions

Abstract

ystic lesions of pancreas are common and challenge more difficulty to detection. Computed tomography (CT) is the best radiology tool for the primer evaluation and follow-up of pancreatic cysts. Purpose. To determine the role of CT scan in the diagnosis of pancreatic cystic lesions, and differentiate weather lesions are malignant or benign. Materials and methods.A prospective study with total of 58 patients were enrolled in the study during the period from 12th June 2021 to 20th May 2022. The study sample consisted of 19 (32.8%) male and 39 (67.2%) female. CT scan features include: lesion sites, parenchymal atrophy, number of cystic lesion, diameter of largest cyst, calcification, ductal dilation, solid components, cyst contour, contrast enhancement, type of cyst, thickness of wall, lymphovascular invasion and communication were collected. CT scan was performed utilizing the Siemens system (SOMATOM Definition AS VA44A; Siemens, Somaris/7 syngo CT 67002-2012B, Germany) and 64-slice (multi-detector) CT system (Philips).Results. The mean age was 41.59±11.9 years. The majority of cysts were situated in head of pancreas (21, 36.2%). About 33 (56.9%) of cases detected one cyst on CT scan. The CT scan detected 47 (81.1%) of non-calcified cysts. Only six-scan showed dilation of duct and 6 (10.3%) cases had cyst with solid component. The cyst contour presented as round in 50 (86.2%) of patients. The majority appear to be homogeneous in 45 (77.6%). About 39 (67.2%) cases detected unilocular cysts. Kappa statistic was revealed that cyst location (P=0.036), number of cyst (P=0.048), ductal dilation (P=0.022), solid component (P=0.003) and type of cyst (P=0.013) had significantly perfect agreement signals. Solid components of cyst showed statistically significant difference in malignant pancreatic cyst more than benign cyst (P=0.004). Furthermore, types of cyst in benign pancreatic tumor were detected significantly different from malignant lesion (P=0.016).Conclusions. CT scan is the easy applicable non-invasive tool of choice for assessment of cystic lesions of pancreas. Round, homogeneous enhancement, oligo-unilocular, non-calcified, nondilated duct, non-solid and thin wall head cyst are the prevalent features detected by CT scan. The most common diameter measured of pancreatic cyst is more than 30 mm. Lymphovascular invasion, solid component and communicated cyst-duct are mostly features of malignant lesions. Detection of cyst site, number, ductal dilation, solid component and type of cyst are significantly helpful to differentiated between malignant and benign pancreatic cysts.