Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis
The purposes of this study were to identify the most common imaging features of autoimmune pancreatitis and to evaluate the utility of MDCT for differentiating autoimmune pancreatitis from two more frequently encountered differential diagnoses--pancreatic ductal adenocarcinoma and acute interstitial...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2015-07, Vol.205 (1), p.2-9 |
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| container_title | American journal of roentgenology (1976) |
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| creator | Lee-Felker, Stephanie A Felker, Ely R Kadell, Barbara Farrell, James Raman, Steven S Sayre, James Lu, David S |
| description | The purposes of this study were to identify the most common imaging features of autoimmune pancreatitis and to evaluate the utility of MDCT for differentiating autoimmune pancreatitis from two more frequently encountered differential diagnoses--pancreatic ductal adenocarcinoma and acute interstitial pancreatitis.
Dual-phase contrast-enhanced MDCT images of 91 patients (39 with autoimmune pancreatitis, 25 with pancreatic ductal adenocarcinoma, 27 with acute interstitial pancreatitis) were evaluated by two radiologists in consensus for distribution of pancreatic abnormality, sausage shape, low-attenuation halo, pancreatic duct dilatation, peripancreatic stranding, lymphadenopathy, biliary abnormality, vascular involvement, and renal lesions. Chi-square tests, multiple logistic regression analysis, and ROC analysis were performed.
The most common imaging features of autoimmune pancreatitis were sausage shape (25/39 [64%]) and low-attenuation halo (23/39 [59%]). Pancreatic duct dilatation (20/25 [80%]) and biliary dilatation (11/25 [44%]) were most frequent in pancreatic ductal adenocarcinoma. Peripancreatic stranding (22/27 [81%]) was most frequent in acute interstitial pancreatitis. Sausage shape, low-attenuation halo, and absence of a pancreatic duct or biliary dilatation differentiated autoimmune pancreatitis from pancreatic ductal adenocarcinoma with an accuracy of 0.88. Sausage shape and absence of peripancreatic stranding differentiated autoimmune pancreatitis from acute interstitial pancreatitis with an accuracy of 0.82. There was no significant difference in the frequency of vascular involvement or of lymphadenopathy among these diagnoses.
Typical cases of autoimmune pancreatitis can be accurately differentiated from pancreatic ductal adenocarcinoma and acute interstitial pancreatitis on the basis of characteristic MDCT features. However, autoimmune pancreatitis should be considered in the presence of atypical features. |
| doi_str_mv | 10.2214/AJR.14.14059 |
| format | Article |
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Dual-phase contrast-enhanced MDCT images of 91 patients (39 with autoimmune pancreatitis, 25 with pancreatic ductal adenocarcinoma, 27 with acute interstitial pancreatitis) were evaluated by two radiologists in consensus for distribution of pancreatic abnormality, sausage shape, low-attenuation halo, pancreatic duct dilatation, peripancreatic stranding, lymphadenopathy, biliary abnormality, vascular involvement, and renal lesions. Chi-square tests, multiple logistic regression analysis, and ROC analysis were performed.
The most common imaging features of autoimmune pancreatitis were sausage shape (25/39 [64%]) and low-attenuation halo (23/39 [59%]). Pancreatic duct dilatation (20/25 [80%]) and biliary dilatation (11/25 [44%]) were most frequent in pancreatic ductal adenocarcinoma. Peripancreatic stranding (22/27 [81%]) was most frequent in acute interstitial pancreatitis. Sausage shape, low-attenuation halo, and absence of a pancreatic duct or biliary dilatation differentiated autoimmune pancreatitis from pancreatic ductal adenocarcinoma with an accuracy of 0.88. Sausage shape and absence of peripancreatic stranding differentiated autoimmune pancreatitis from acute interstitial pancreatitis with an accuracy of 0.82. There was no significant difference in the frequency of vascular involvement or of lymphadenopathy among these diagnoses.
Typical cases of autoimmune pancreatitis can be accurately differentiated from pancreatic ductal adenocarcinoma and acute interstitial pancreatitis on the basis of characteristic MDCT features. However, autoimmune pancreatitis should be considered in the presence of atypical features.</description><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.14.14059</identifier><identifier>PMID: 26102377</identifier><language>eng</language><publisher>United States</publisher><subject>Acute Disease ; Adenocarcinoma - diagnostic imaging ; Adult ; Aged ; Autoimmune Diseases - diagnostic imaging ; Carcinoma, Pancreatic Ductal - diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography - methods ; Pancreatic Neoplasms - diagnostic imaging ; Pancreatitis - diagnostic imaging ; Retrospective Studies</subject><ispartof>American journal of roentgenology (1976), 2015-07, Vol.205 (1), p.2-9</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26102377$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee-Felker, Stephanie A</creatorcontrib><creatorcontrib>Felker, Ely R</creatorcontrib><creatorcontrib>Kadell, Barbara</creatorcontrib><creatorcontrib>Farrell, James</creatorcontrib><creatorcontrib>Raman, Steven S</creatorcontrib><creatorcontrib>Sayre, James</creatorcontrib><creatorcontrib>Lu, David S</creatorcontrib><title>Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>The purposes of this study were to identify the most common imaging features of autoimmune pancreatitis and to evaluate the utility of MDCT for differentiating autoimmune pancreatitis from two more frequently encountered differential diagnoses--pancreatic ductal adenocarcinoma and acute interstitial pancreatitis.
Dual-phase contrast-enhanced MDCT images of 91 patients (39 with autoimmune pancreatitis, 25 with pancreatic ductal adenocarcinoma, 27 with acute interstitial pancreatitis) were evaluated by two radiologists in consensus for distribution of pancreatic abnormality, sausage shape, low-attenuation halo, pancreatic duct dilatation, peripancreatic stranding, lymphadenopathy, biliary abnormality, vascular involvement, and renal lesions. Chi-square tests, multiple logistic regression analysis, and ROC analysis were performed.
The most common imaging features of autoimmune pancreatitis were sausage shape (25/39 [64%]) and low-attenuation halo (23/39 [59%]). Pancreatic duct dilatation (20/25 [80%]) and biliary dilatation (11/25 [44%]) were most frequent in pancreatic ductal adenocarcinoma. Peripancreatic stranding (22/27 [81%]) was most frequent in acute interstitial pancreatitis. Sausage shape, low-attenuation halo, and absence of a pancreatic duct or biliary dilatation differentiated autoimmune pancreatitis from pancreatic ductal adenocarcinoma with an accuracy of 0.88. Sausage shape and absence of peripancreatic stranding differentiated autoimmune pancreatitis from acute interstitial pancreatitis with an accuracy of 0.82. There was no significant difference in the frequency of vascular involvement or of lymphadenopathy among these diagnoses.
Typical cases of autoimmune pancreatitis can be accurately differentiated from pancreatic ductal adenocarcinoma and acute interstitial pancreatitis on the basis of characteristic MDCT features. However, autoimmune pancreatitis should be considered in the presence of atypical features.</description><subject>Acute Disease</subject><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adult</subject><subject>Aged</subject><subject>Autoimmune Diseases - diagnostic imaging</subject><subject>Carcinoma, Pancreatic Ductal - diagnostic imaging</subject><subject>Contrast Media</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multidetector Computed Tomography - methods</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Pancreatitis - diagnostic imaging</subject><subject>Retrospective Studies</subject><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkEFLAzEQhYMgtlZvniVHL62ZZDfZHJfWaqWiSHte0t0EIpukJtmD_94VKwgDc5jvDe89hG6ALCiF4r5-fl9AMQ4p5RmaQlnwOYMCJugypQ9CiKikuEATyoFQJsQUuX3SOBj8slrucA54ZY3RUftsVda4HnKwzg1e4zfl26hVttkmvI7B4dXQZtXjutM-tCq21gensPId3visY_pBx_t_4RU6N6pP-vq0Z2i_ftgtn-bb18fNst7OjxQgz-Xon0MpWnogBXDKiVHQqW4M0GphRFWVnTwUpRGclVLzqiuZLMEwTiUXULAZuvv9e4zhc9ApN86mVve98joMqQEugVYMiBzR2xM6HJzummO0TsWv5q8i9g1y12U8</recordid><startdate>201507</startdate><enddate>201507</enddate><creator>Lee-Felker, Stephanie A</creator><creator>Felker, Ely R</creator><creator>Kadell, Barbara</creator><creator>Farrell, James</creator><creator>Raman, Steven S</creator><creator>Sayre, James</creator><creator>Lu, David S</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201507</creationdate><title>Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis</title><author>Lee-Felker, Stephanie A ; Felker, Ely R ; Kadell, Barbara ; Farrell, James ; Raman, Steven S ; Sayre, James ; Lu, David S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-94056157c2b0416260fa1dad000ce7f7885d9b45f76359e68d53951f362967143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Disease</topic><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Adult</topic><topic>Aged</topic><topic>Autoimmune Diseases - diagnostic imaging</topic><topic>Carcinoma, Pancreatic Ductal - diagnostic imaging</topic><topic>Contrast Media</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multidetector Computed Tomography - methods</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Pancreatitis - diagnostic imaging</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee-Felker, Stephanie A</creatorcontrib><creatorcontrib>Felker, Ely R</creatorcontrib><creatorcontrib>Kadell, Barbara</creatorcontrib><creatorcontrib>Farrell, James</creatorcontrib><creatorcontrib>Raman, Steven S</creatorcontrib><creatorcontrib>Sayre, James</creatorcontrib><creatorcontrib>Lu, David S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee-Felker, Stephanie A</au><au>Felker, Ely R</au><au>Kadell, Barbara</au><au>Farrell, James</au><au>Raman, Steven S</au><au>Sayre, James</au><au>Lu, David S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2015-07</date><risdate>2015</risdate><volume>205</volume><issue>1</issue><spage>2</spage><epage>9</epage><pages>2-9</pages><eissn>1546-3141</eissn><abstract>The purposes of this study were to identify the most common imaging features of autoimmune pancreatitis and to evaluate the utility of MDCT for differentiating autoimmune pancreatitis from two more frequently encountered differential diagnoses--pancreatic ductal adenocarcinoma and acute interstitial pancreatitis.
Dual-phase contrast-enhanced MDCT images of 91 patients (39 with autoimmune pancreatitis, 25 with pancreatic ductal adenocarcinoma, 27 with acute interstitial pancreatitis) were evaluated by two radiologists in consensus for distribution of pancreatic abnormality, sausage shape, low-attenuation halo, pancreatic duct dilatation, peripancreatic stranding, lymphadenopathy, biliary abnormality, vascular involvement, and renal lesions. Chi-square tests, multiple logistic regression analysis, and ROC analysis were performed.
The most common imaging features of autoimmune pancreatitis were sausage shape (25/39 [64%]) and low-attenuation halo (23/39 [59%]). Pancreatic duct dilatation (20/25 [80%]) and biliary dilatation (11/25 [44%]) were most frequent in pancreatic ductal adenocarcinoma. Peripancreatic stranding (22/27 [81%]) was most frequent in acute interstitial pancreatitis. Sausage shape, low-attenuation halo, and absence of a pancreatic duct or biliary dilatation differentiated autoimmune pancreatitis from pancreatic ductal adenocarcinoma with an accuracy of 0.88. Sausage shape and absence of peripancreatic stranding differentiated autoimmune pancreatitis from acute interstitial pancreatitis with an accuracy of 0.82. There was no significant difference in the frequency of vascular involvement or of lymphadenopathy among these diagnoses.
Typical cases of autoimmune pancreatitis can be accurately differentiated from pancreatic ductal adenocarcinoma and acute interstitial pancreatitis on the basis of characteristic MDCT features. However, autoimmune pancreatitis should be considered in the presence of atypical features.</abstract><cop>United States</cop><pmid>26102377</pmid><doi>10.2214/AJR.14.14059</doi><tpages>8</tpages></addata></record> |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | Acute Disease Adenocarcinoma - diagnostic imaging Adult Aged Autoimmune Diseases - diagnostic imaging Carcinoma, Pancreatic Ductal - diagnostic imaging Contrast Media Diagnosis, Differential Female Humans Male Middle Aged Multidetector Computed Tomography - methods Pancreatic Neoplasms - diagnostic imaging Pancreatitis - diagnostic imaging Retrospective Studies |
| title | Use of MDCT to Differentiate Autoimmune Pancreatitis From Ductal Adenocarcinoma and Interstitial Pancreatitis |
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