Wirsungocele: evaluation by MRCP and clinical significance

Evrimler, Şehnaz; Swensson, Jordan; Soufi, Mazhar; Tirkes, Temel; Schmidt, C. Max; Akisik, Fatih

doi:10.1007/s00261-020-02675-4

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…The projection images of the entire ductal system of pancreas can be achieved via endoscopic retrograde or magnetic resonance cholangiopancreatography (ERCP and MRCP). The non-invasive MRCP gives an image of lesser quality, and ERCP is thus considered to be the reference method [16]. In cases of equivocal and mild pancreatitis, the appearance of abnormal side branches is highly important for early diagnosis [17].…”

Section: Discussionmentioning

confidence: 99%

Establishing correlations between normal pancreatic and submandibular gland ducts

2022

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Background The objectives of this study were to evaluate the relationship between ductal morphometry and ramification patterns in the submandibular gland and pancreas in order to validate their common fractal dimension. Methods X-ray ductography with software-aided morphometry were obtained by injecting barium sulphate in the ducts of post-mortem submandibular gland and pancreas specimens harvested from 42 adult individuals. Results Three cases were excluded from the study because of underlying pathology. There was a significant correlation between the length of the main pancreatic duct (MPD) and the intraglandular portion of the right submandibular duct (SMD) (r = 0.3616; p = 0.028), and left SMD (r = 0.595; p < 0.01), respectively, but their maximal diameters did not correlate (r = 0.139—0.311; p > 0.05). Both dimensions of the SMD showed a significant right-left correlation (p < 0.05). The number of MPD side branches (mean = 37) correlated with the number of side branches of left SMD, but not with the right one (mean = 9). Tortuosity was observed in 54% of the MPD, 32% of the right SMD, and 24% of the left SMD, with mutual association only between the two salivary glands. Conclusions Although the length of intraglandular SMD and MPD correlate, other morphometric ductal features do not, thus suggesting a more complex relationship between the two digestive glands.

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Section: Discussionmentioning

confidence: 99%

Establishing correlations between normal pancreatic and submandibular gland ducts

2022

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“…The projection images of the entire ductal system of pancreas can be achieved via endoscopic retrograde or magnetic resonance cholangiopancreatography (ERCP and MRCP). The non-invasive MRCP gives an image of lesser quality, and ERCP is thus considered to be the reference method [21]. In cases of equivocal and mild pancreatitis, the appearance of abnormal side branches is highly important for early diagnosis [22].…”

Section: Discussionmentioning

confidence: 99%

Establishing Correlations Between Normal Pancreatic and Submandibular Gland Ducts

Štimec

Ignjatović

Lobrinus

2021

Preprint

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BACKGROUND. The objectives of this study were to evaluate the relationship between ductal morphometry and ramification patterns in the submandibular gland and pancreas in order to validate their common fractal dimension. METHODS. X-ray ductography with software-aided morphometry were obtained by injecting barium sulphate in the ducts of post-mortem submandibular gland and pancreas specimens harvested from 42 adult individuals. RESULTS. Three cases were excluded from the study because of underlying pathology. There was a significant correlation between the length of the main pancreatic duct (MPD) and the intraglandular portion of the right submandibular duct (SMD) (r = 0.3616; p=0.028), and left SMD (r = 0.595; p<0.01), respectively, but their maximal diameters did not correlate (r = 0.139 - 0.311; p>0.05). Both dimensions of the SMD showed a significant right-left correlation (p<0.05). The number of MPD side branches (mean=37) correlated with the number of side branches of left SMD, but not with the right one (mean = 9). Tortuosity was observed in 54% of the MPD, 32% of the right SMD, and 24% of the left SMD, with mutual association only between the two salivary glands. CONCLUSIONS. Although the length of intraglandular SMD and MPD correlate, other morphometric ductal features do not, thus suggesting a more complex relationship between the two digestive glands.

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“…While Wirsungoceles are more commonly thought to be an incidental finding, a recent study suggested that Wirsungocele was significantly more likely to be present in patients with RAP than those without RAP [30]. Further evidence indicates that patients who have both pancreas divisum and a Santorinicele are at increased risk for RAP, possibly related to transient obstruction of the minor papilla [31] (FIGURE 4b).…”

Section: Why We Use Secretin Established Indications For Secretinmentioning

confidence: 99%

Secretin-Enhanced MRCP: How and Why—AJR Expert Panel Narrative Review

Swensson

Zaheer

Conwell

et al. 2021

American Journal of Roentgenology

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Secretin-enhanced MRCP (S-MRCP) provides multiple advantages compared with standard MRCP for imaging the pancreaticobiliary tree. By using secretin to induce fluid production from the pancreas, and leveraging fluid-sensitive MRCP sequences, S-MRCP increases visualization of ductal anatomy and provides insight into pancreatic function, allowing radiologists to offer additional insight for a range of pancreatic-related conditions. This narrative review provides detailed information on the practical implementation of S-MRCP, including patient preparation, logistics of secretin administration, and dynamic secretin-enhanced MRCP acquisition. Considerations are given for radiologists' interpretation and reporting of S-MRCP examinations, including assessment of dynamic compliance of the main pancreatic duct and of duodenal fluid volume. Established indications for S-MRCP are reviewed, including pancreas divisum, anomalous pancreaticobiliary junction, Santorinicele, Wirsungocele, chronic pancreatitis, main pancreatic duct stenosis, and assessment of complex postoperative anatomy. Equivocal or controversial indications are also presented, along with the authors' approach to such indications; these include acute or recurrent acute pancreatitis, pancreatic exocrine function, sphincter of Oddi dysfunction, and pancreatic neoplasms.

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Wirsungocele: evaluation by MRCP and clinical significance

Cited by 3 publications

References 26 publications

Establishing correlations between normal pancreatic and submandibular gland ducts

Establishing correlations between normal pancreatic and submandibular gland ducts

Establishing Correlations Between Normal Pancreatic and Submandibular Gland Ducts

Secretin-Enhanced MRCP: How and Why—AJR Expert Panel Narrative Review

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