Paraduodenal Pancreatitis: Clinical Performance of MR Imaging in Distinguishing from Carcinoma

Abstract

To evaluate the diagnostic performance of contrast material-enhanced magnetic resonance (MR) imaging for distinguishing paraduodenal pancreatitis (PDP) from pancreatic head duct adenocarcinoma (CA) in patients with diagnoses confirmed by histopathologic analysis.

Clinical outcomes and prevalence of cancer in patients with possible groove pancreatitis

“…GP patients are more often smokers who present without jaundice and abrupt change of caliber of the CBD but with cysts in the groove area. Our findings, presented in Table , are in line with previous studies . Although Gabata et al and Kalb et al also showed that cystic lesions in patients with cancer are rare (11–13% of patients compared to 20% in our cohort), Ishigami et al reported a high prevalence of cysts in cancer patients (57%).…”

The role of diffusion-weighted imaging in the diagnosis of thymic metastasis

“…This was following an observation by Adsay and Zamboni that all these entities shared common clinicopathological features of a fibroinflammatory process centered at the descending duodenum (primarily in the minor papilla region) in young chronic alcoholic men, often associated with varying degrees of involvement of the pancreaticoduodenal groove and/ or the adjoining pancreas [4,5]. Since then, the term paraduodenal pancreatitis has been popular in the medical literature [5][6][7][8][9][10]. Of course, what matters is that the entity should be correctly diagnosed and differentiated from pancreatic adenocarcinoma and not what it is called.…”

“…They used the following three diagnostic criteria for differentiating PP from carcinoma, namely, focal thickening of the descending duodenum, mucosal hyperenhancement of the descending duodenum, and cystic change in the region of the accessory duct of Santorini. The authors reported that simultaneous presence of these three findings allowed differentiation of PP from pancreatic carcinoma with a diagnostic accuracy of 87.2% (41 of 47 patients) and excluded cancer with a negative predictive value of 92.9% (26 of 28 cases) [6]. The readers should therefore vigilantly look for these imaging manifestations while raising the possibility of groove/ paraduodenal pancreatitis.…”

“…Nevertheless, it is vital to stay abreast with the newer terminologies. This becomes especially relevant while collating up-to-date medical information on search tools such as PubMed [5][6][7][8][9][10].…”

“…Additional to the information collated by Hungerford et al, we would like to highlight the results of seminal work done by Kalb et al [6] in this area. Kalb and colleagues studied the diagnostic performance of contrast-material-enhanced magnetic resonance imaging for distinguishing PP from pancreatic carcinoma in 47 patients who had undergone Whipple surgery.…”