Abstract
Objective: We retrospectively compared the ability of abdominal ultrasound (US) and magnetic resonance cholangiopancreatography (MRCP) to depict intraductal papillary mucinous neoplasms (IPMN), which can be precursors of pancreatic cancer.
Methods: In 170 patients with IPMN, lesion detection by US was examined according to site and size of cysts. Additionally, clinical and imaging features associated with need for surgery during follow-up were determined.
Results: Relative to lesion depiction with MRCP as the standard, cyst detection by US was significantly better in the body of the pancreas than in the head or tail. For small cysts (< 10 mm), US detection was significantly better in the body than in the tail. Among 170 patients, 12 (7.1%) underwent surgical resection during follow-up. A widening main pancreatic duct (MPD; diameter increase ≥ 0.2 mm/year) and greater age (≥ 70 years) were significantly and independently associated with need for surgical resection.
Conclusion: The ability of US to detect cysts in the head and tail of the pancreas is limited, particularly in the latter. Since multiple cysts are relatively frequent in these regions, MRCP should also be performed when a cyst is detected in the body by US. Older individuals and those with relatively rapid widening of the MPD should be considered carefully for surgical resection.
