Feline pancreatic ducts are consistently identified on CT and more likely to be dilated in the body of pancreas in cats with elevated feline pancreatic lipase immunoreactivity

Abstract

Feline pancreatitis is a challenge to diagnose and no previously published study has described the CT characteristics of the pancreatic duct (PD) in cats. The current prospective analytical study was performed to identify and describe the CT characteristics of the PD in normal cats and to compare that to those cats with an elevated feline pancreatic lipase immunoreactivity (fPLI). Contrastenhanced CT was performed in 16 normal cats and 13 cats with an elevated fPLI. Two ACVRcertified radiologists blinded to the fPLI status assessed whether or not the PD could be identified, contrast phase during which the PD was most conspicuous, and PD shape in the body, right and left lobes. A second-year radiology resident blinded to the fPLI status measured maximum PD diameter and PD:parenchyma. The PD was identified in 84 of 87 pancreatic segments, which was most conspicuous in the portal phase in 28 of 29 cats. The PD shape was tubular (48/84), tapered (34/84), or beaded (2/84) with no significant difference (P = 1.0 to .1615) between groups. Mean maximal PD diameters of normal cats were 1.5-1.7 mm, which was significantly larger in the body of the pancreas in cats with an elevated fPLI (2.4 mm, P = .0313). Mean PD:parenchyma was not significantly different between groups (P = .2001 to .949). In conclusion, the feline PD can be consistently identified on CT, for which the portal phase is preferred. Cats with an elevated fPLI are more likely to exhibit dilation of the PD in the body of the pancreas on CT. K E Y W O R D Sabdomen, pancreas, pancreatitis, pancreatolith, size

ACVIM consensus statement on pancreatitis in cats

“…Recent studies have established the multiphase contrast enhanced computed tomography (CT) features of the normal and abnormal feline pancreas 78‐81 . The pancreas in healthy cats enhances homogenously on arterial, portal, and delayed phase scans.…”

“…76,77 Recent studies have established the multiphase contrast enhanced computed tomography (CT) features of the normal and abnormal feline pancreas. [78][79][80][81] The pancreas in healthy cats enhances homogenously on arterial, portal, and delayed phase scans. The pancreas is hypoattenuating or isoattenuating to the liver and spleen on precontrast scans.…”

Abdominal ultrasound and clinicopathologic findings in 22 cats with exocrine pancreatic insufficiency

“…In that study, mean pancreatic duct size in healthy older cats (mean age, 13 ± 3 years) was 1.3 mm, ranging between 0.06 and 2.4 mm, with a significant association between increased pancreatic duct width and age 5 . Nevertheless, a recent study using computed tomography to evaluate the pancreatic duct in healthy cats and in cats with pancreatitis found that pancreatic duct diameter was significantly larger in cats with increased fPLI concentration than in healthy cats 15 . Pancreatic duct dilatation (>2.5 mm), or pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 (46%) cats in our study, with mean pancreatic duct diameter measurements of 2.4 mm, 2.9 mm, and 4.3 mm for the left limb, body, and right limb, respectively, and with measurements up to 11 mm, higher than previously reported normal values, even in older cats.…”

“… 5 Nevertheless, a recent study using computed tomography to evaluate the pancreatic duct in healthy cats and in cats with pancreatitis found that pancreatic duct diameter was significantly larger in cats with increased fPLI concentration than in healthy cats. 15 Pancreatic duct dilatation (>2.5 mm), or pancreatic duct tortuosity with variable diameter, or both were seen in 6/13 (46%) cats in our study, with mean pancreatic duct diameter measurements of 2.4 mm, 2.9 mm, and 4.3 mm for the left limb, body, and right limb, respectively, and with measurements up to 11 mm, higher than previously reported normal values, even in older cats. Additionally, despite a high correlation coefficient, a significant correlation between age and pancreatic duct size was not identified in our study; however, this result may have been because of our small sample size and lack of statistical power.…”

Laparoscopic partial pancreatectomy of the left limb using a harmonic scalpel in nine cats

“…11 In our study, cats had proximal resections, but the pancreatic tissue and duct diameter are significantly smaller than that of humans. 12,13 The feline maximal pancreatic duct diameter is 1.5-1.7 mm whereas the human pancreatic duct diameter in the body of the pancreas is 2.5-3.0 mm. Conversely, the pancreatic duct diameter in the tail of the human is closer to the cat measuring 2.0 mm on average.…”