1. Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT.
- Author
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Furuhashi N, Suzuki K, Sakurai Y, Ikeda M, Kawai Y, and Naganawa S
- Subjects
- Adult, Aged, Aged, 80 and over, Autoimmune Diseases diagnosis, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Pancreas diagnostic imaging, Retrospective Studies, Sensitivity and Specificity, Pancreatic Neoplasms, Contrast Media, Pancreatic Neoplasms diagnostic imaging, Pancreatitis diagnostic imaging, Radiographic Image Enhancement methods, Tomography, X-Ray Computed methods
- Abstract
Objectives: To evaluate the utility of multiphase contrast-enhanced computed tomography (CT) findings alone and in combination for differentiating focal-type autoimmune pancreatitis (f-AIP) from pancreatic carcinoma (PC)., Methods: The study group comprised 22 f-AIP lesions and 61 PC lesions. Two radiologists independently evaluated CT findings. Frequencies of findings were compared between f-AIP and PC. Statistical, univariate and multivariate analyses were performed., Results: Homogeneous enhancement during the portal phase (AIP, 59 % vs. PC, 3 %; P < 0.001), dotted enhancement during the pancreatic phase (50 % vs. 7 %; P < 0.001), duct-penetrating sign (46 % vs. 2 %; P < 0.001), enhanced duct sign (36 % vs. 2 %; P < 0.001) and capsule-like rim (46 % vs. 3 %; P < 0.001) were more frequently observed in AIP. Ring-like enhancement during the delayed phase (5 % vs. 46 %; P < 0.001) and peripancreatic strands with a length of at least 10 mm (5 % vs. 39 %; P = 0.001) were more frequently observed in PC. AIP was identified with 82 % sensitivity and 98 % specificity using four of these seven findings. Multivariate analysis revealed significant differences in dotted enhancement (P = 0.004), duct-penetrating sign (P < 0.001) and capsule-like rim (P = 0.007)., Conclusions: The combination of CT findings may allow improvements in differentiating f-AIP from PC., Key Points: • f-AIP can mimic PC on imaging findings. • The differentiation of f-AIP from PC is important in patient management. • Some CT findings can be used to identify AIP. • The combination of CT findings will improve differentiation from PC.
- Published
- 2015
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