Incidentally detected pancreatic duct dilatation on ultrasound and role of MRI
- 04-10-2024
- Magnetic Resonance Imaging
- Research
Published in:
- Authors
- Abraham Fourie Bezuidenhout
- Kristy D. Lee
- Meghavi Mashar
- Mohammed Nakhaei
- Lauren Phung
- Karen S. Lee
- Jesse L. Wei
- Olga R. Brook
- Koenraad J. Mortele
- Published in
- Abdominal Radiology | Issue 4/2025
Abstract
Objective
The clinical significance of incidentally detected pancreatic duct (PD) dilatation at ultrasound (US) without a visualized underlying cause is unclear. We aimed to assess the role of subsequent MRI (including MRCP) and to identify US imaging and laboratory findings predictive of underlying pancreaticobiliary malignancy at the time of initial US.
Materials and methods
Patients with incidentally detected PD dilatation at ultrasound from 2011 to 2019 that had an ensuing MRI were included. Based on MRI results patients were divided into three groups: malignant pancreaticobiliary causes, benign causes and idiopathic PD dilatation. Subsequently the diagnostic ability of MRI was assessed. Initial ultrasound findings and laboratory results were compared between groups to identify predictors of underlying pancreaticobiliary pathology. A p-value < .05 was considered statistically significant.
Results
In 37/59 (63%) patients PD dilatation was confirmed on MRI. MRI demonstrated malignant 7/59 (12%) and benign 10/59 (17%) causes of PD dilatation detected at initial ultrasound. Sensitivity, specificity, negative predictive value, positive predictive value and accuracy of MRI to ascertain the cause of PD dilatation was 89%, 100%, 95%, 100% and 97% respectively. Patients with a larger magnitude of PD dilatation, concomitant CBD dilatation and elevated lipase values were more likely to have underlying pancreaticobiliary malignancy (p < 0.05). No patient with initial negative MRI had pancreaticobiliary malignancy on subsequent work-up.
Conclusion
Incidentally detected PD dilatation on ultrasound is an important finding and should prompt referral to MRI. MRI is an accurate, noninvasive method for identifying the underlying cause of PD dilatation in these patients and in excluding pancreaticobiliary malignancy.
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- Title
- Incidentally detected pancreatic duct dilatation on ultrasound and role of MRI
- Authors
-
Abraham Fourie Bezuidenhout
Kristy D. Lee
Meghavi Mashar
Mohammed Nakhaei
Lauren Phung
Karen S. Lee
Jesse L. Wei
Olga R. Brook
Koenraad J. Mortele
- Publication date
- 04-10-2024
- Publisher
- Springer US
- Keywords
-
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Magnetic Resonance Cholangio Pancreatography
Endoscopic Retrograde Cholangiopancreatography
Chronic Pancreatitis - Published in
-
Abdominal Radiology / Issue 4/2025
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058 - DOI
- https://doi.org/10.1007/s00261-024-04583-3
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