Marie-Pierre Vullierme

Are pancreatic calcifications specific for the diagnosis of chronic pancreatitis? A multidetector-row CT analysis

AIMnTo retrospectively establish the most frequently encountered diagnoses in patients with pancreatic calcifications and to investigate whether the association of certain findings could be helpful for diagnosis.nnnMATERIALS AND METHODSnOne hundred and three patients were included in the study. The location and distribution of calcifications; presence, nature, and enhancement pattern of pancreatic lesions; pancreatic atrophy and ductal dilatation were recorded. Differences between patients with chronic pancreatitis and patients with other entities were compared by using Fishers exact test.nnnRESULTSnPatients had chronic pancreatitis (n=70), neuroendocrine tumours (n=14), intraductal papillary mucinous neoplasm (n=11), pancreatic adenocarcinoma (n=4), serous cystadenoma (n=4). Four CT findings had a specificity of over 60% for the diagnosis of chronic pancreatitis: parenchymal calcifications, intraductal calcifications, parenchymal atrophy, and cystic lesions. When at least two of these four criteria were used in combination, 54 of 70 (77%) patients with chronic pancreatitis could be identified, but only 17 of 33 (51%) patients with other diseases. When at least three of these four criteria were present, a specificity of 79% for the diagnosis of chronic pancreatitis was achieved.nnnCONCLUSIONnCertain findings are noted more often in chronic pancreatitis than in other pancreatic diseases. The presence of a combination of CT findings can suggest chronic pancreatitis and be helpful in diagnosis.

Tératome kystique du pancréas.

Resume Le diagnostic preoperatoire de certitude des tumeurs kystiques du pancreas est parfois difficile a etablir. Il repose essentiellement sur les examens morphologiques et le dosage des marqueurs tumoraux intrakystiques, mais ceux-ci peuvent etre pris en defaut s’il s’agit d’une lesion plus exceptionnelle qu’un cystadenome. Nous rapportons l’observation d’une femme de 45 ans operee pour un teratome mature kystique benin avec contingent endocrine dont l’aspect en imagerie et le contenu intrakystique en ACE et CA 72.4 evoquaient un cystadenome mucineux degenere.

Estimation of the prevalence of intraductal papillary mucinous neoplasm of the pancreas in the French population through patients waiting for liver transplantation

Background and aims Some studies have explored the prevalence of pancreatic cystic lesions (PCLs). Only one study based on magnetic resonance imaging (MRI) report examination focused specifically on intraductal papillary mucinous neoplasm (IPMN) in a European general population. The aim of this study was to evaluate the prevalence of IPMN in a population of patients who had MRI for a non-pancreatic disease. Methods We conducted a retrospective, single-center study. All consecutive patients placed on the French liver transplant waiting list who had MRI for a non-pancreatic disease before liver transplantation between 2009 and 2013 were included. Only diagnoses consistent with IPMN were retained (cyst(s) clearly communicating with the main pancreatic duct). Results Among 315 patients on the national waiting list, 212 patients had an MRI. PCLs with ductal communication were diagnosed in 14 patients (6.6%; six women, eight men, median age 62 years (45–70)). Liver disease was caused by a virus in seven cases, alcohol in three cases, other in four cases (multiple causes possible). Four patients had hepatocellular carcinoma. No patient had clinical or radiological sign of chronic pancreatitis. The median diameter of the largest cystic lesion was 14u2009mm (7–22). The number of PCLs was one (nu2009=u20094), two (nu2009=u20092), four (nu2009=u20093), five (nu2009=u20092),u2009>u20095 (nu2009=u20093), respectively. There was no worrisome or main pancreatic duct involvement. Conclusions Prevalence of pancreatic cystic lesions consistent with the diagnosis of IPMN was 6.6% in French patients waiting for liver transplantation. These results underscore that IPMN can be considered as a public health problem and justify a screening.