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Differentiation of focal-type autoimmune pancreatitis from pancreatic carcinoma: assessment by multiphase contrast-enhanced CT.

Authors :
Furuhashi, Naohiro
Suzuki, Kojiro
Sakurai, Yusuke
Ikeda, Mitsuru
Kawai, Yuichi
Naganawa, Shinji
Source :
European Radiology. May2015, Vol. 25 Issue 5, p1366-1374. 9p.
Publication Year :
2015

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09387994
Volume :
25
Issue :
5
Database :
Academic Search Index
Journal :
European Radiology
Publication Type :
Academic Journal
Accession number :
102013270
Full Text :
https://doi.org/10.1007/s00330-014-3512-3