Magnetic resonance pancreatography: comparison of two- and three-dimensional sequences for assessment of intraductal papillary mucinous neoplasm of the pancreas

Abstract

The purpose was to compare two-dimensional (2D) magnetic resonance pancreatography (MRP) with 3D MRP to evaluate intraductal papillary mucinous neoplasm (IPMN). Thirty-four patients (22 men, 12 women; age range, 45-80 years) with IPMN (n = 40) were examined with MRP on 2D and 3D sequences. Two readers independently reviewed the images to assess the overall image quality, artifacts, lesion location, communication with main pancreatic duct, and potential for malignancy. The readers assigned their confidence level (1-5) for predicting ductal communication of the lesion. The results of MRP were compared with endoscopic retrograde pancreatography and surgical and histopathologic findings. Studies obtained with 3D MRP were of significantly higher technical quality than those obtained with 2D MRP. Although 3D MRP showed higher area under the ROC curve (Az) values for predicting ductal communication of the lesion, there was no statistical significance between Az values of 2D and 3D MRP (Az for 2D = 0.821, 0.864 for readers 1 and 2, respectively, and Az for 3D= 0.964, 0.921). Accuracies for discriminating benign from malignant lesions were 70 and 67.5% (reader 1 and 2, respectively, for 2D) and 62.5 and 80.1% (3D). 3D MRP showed superior image quality to that of 2D MRP but did not increase the diagnostic accuracy for predicting ductal communication of the lesion.

Criteria for Determining Malignancy in Pancreatic Intraductal Papillary Mucinous Neoplasm Based on Computed Tomography

“…Furthermore, the evaluation of pancreatic lesions by EUS is more invasive and largely dependent on the experience of the individual examiner as well as the anatomical conditions of the patient [24] . Limitations of pancreatic MRI include the long duration of the examination as well as movement artefacts [25] . Therefore, abdominal CT scans will likely remain important components of the diagnostic workup for pancreatic IPMN.…”

Endoscopic Ultrasonography in Management of Cystic Disease of the Pancreas

“…The accuracy of CT scan and MRI in differentiating mucinous from non-mucinous cyst was 71% and 84% respectively, while the accuracy of CT vs MRI in differentiating benign from malignant cyst was 75-78% vs 78-86% (not statistically significant) [35]. Recently, 3D MRCP was shown to improve the image quality of pancreatic cysts [36]. However, 3D MRCP had similar diagnostic performance to 2D MRCP in differentiating benign from malignant cysts [37].…”

Magnetic resonance cholangiopancreatography: Comparison of two- and three-dimensional sequences for the assessment of pancreatic cystic lesions

“…Certain studies have compared 2D and 3D MRCP for the visualization of the pancreatobiliary system (1–12). However, studies that have compared the use of 2D and 3D MRCP for the visualization of pancreatic cystic lesions focused solely on intraductal papillary mucinous neoplasm (IPMN) (5,8). The two previous studies concluded that image quality of the pancreatic duct of 3D MRCP was superior to that of 2D MRCP, 3D MRCP identified the morphological details of IPMN with more confidence compared with 2D MRCP.…”