Clinical significance of main pancreatic duct dilation on computed tomography: Single and double duct dilation

Abstract

AIM:To study the patients with main pancreatic duct dilation on computed tomography (CT) and thereby to provide the predictive criteria to identify patients at high risk of significant diseases, such as pancreatic cancer, and to avoid unnecessary work up for patients at low risk of such diseases. METHODS:Patients with dilation of the main pancreatic duct on CT at Emory University Hospital in 2002 were identified by computer search. Clinical course and ultimate diagnosis were obtained in all the identified patients by abstraction of their computer database records. RESULTS:Seventy-seven patients were identified in this study. Chronic pancreatitis and pancreatic cancer were the most common causes of the main pancreatic duct dilation on CT. Although the majority of patients with isolated dilation of the main pancreatic duct (single duct dilation) had chronic pancreatitis, one-third of patients with single duct dilation but without chronic pancreatitis had pancreatic malignancies, whereas most of patients with concomitant biliary duct dilation (double duct dilation) had pancreatic cancer. CONCLUSION:Patients with pancreatic double duct dilation need extensive work up and careful followup since a majority of these patients are ultimately diagnosed with pancreatic cancer. Patients with single duct dilation, especially such patients without any evidence of chronic pancreatitis, also need careful follow-up since the possibility of pancreatic malignancy, including adenocarcinoma and intraductal papillary mucinous tumors, is still high.© 2007 The WJG Press. All rights reserved.

Ratio of Pancreatic Duct Caliber to Width of Pancreatic Gland by Endosonography Is Predictive of Pancreatic Cancer

“…21 We also acknowledge that although statistical significance was detected for the association of the PDG ratio and PC, the 95% CI for the PDG ratio was very wide due to small sample size of cancer cases (n = 34) which is the outcome of interest. On the basis of CT scan findings, it is very difficult to differentiate pancreatitis from PC based on the degree of pancreatic ductal dilation alone, although PD dilation could be slightly more prominent in patients with PC.…”

Advanced Imaging of Chronic Pancreatitis

“…One retrospective study showed that in 77 patients with ductal abnormalities on CT, 51 had isolated main pancreatic duct dilatation, of which 37 (73%) had chronic pancreatitis and two (4%) had pancreatic carcinoma. The 26 remaining patients had double duct dilatation, of which 15 (58%) had pancreatic carcinoma and three (12%) had chronic pancreatitis [8].…”

The effect of solid pancreatic mass lesions on pancreatic duct diameter at endoscopic ultrasound

“…[7] However, there are still many questions regarding the role of pancreatic cancer in dilation of the PD. In this study, we aimed to evaluate the significance of PD dilation on EUS, CT, or MRI in patients undergoing EUS for pancreatic indications.…”