Image Comparative Analysis of Tumorous Acute Pancreatitis and Non-Tumorous Acute Pancreatitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 YANGFan ^1,2 ,  CHENWei-xia ¹

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;
2. Department of Radiology, Chengdu First People's Hospital, Chengdu 610041, Sichuan Province, China;

Corresponding author：

CHENWei-xia, Email: wxchen25@126.com

Keywords：

Pancreatic tumor; Pancreatitis; Acute; Computed tomography; Magnetic resonance imaging

DOI：

10.7507/1007-9424.20150329

Video：

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Objective To comparatively analyze the image features of tumorous acute pancreatitis (T-AP) and non-tumorous acute pancreatitis (NT-AP). Methods Sixteen cases of histopathologically proven pancreatic tumors inducing acute pancreatitis and 30 cases of non-tumorous acute pancreatitis were collected, and studied their CT and MRI features. Results There were 16 cases (100%) with focal nodules or masses in T-AP group and none in NT-AP group. The average innerdiameter of main pancreatic ducts in T-AP group was (9.6±6.8) mm, in which 14 cases (87.5%) were dilated. And the average innerdiameter of main pancreatic ducts in NT-AP group was (2.9±0.9) mm, in which 7 cases (23.3%) were dilated. The cases of sinistral portal hypertension (SPH), accompanying cholelithiasis and lymphadenosis between the two groups were 10 (62.5%), 3 (18.8%), 14 (87.5%), and 1 (3.4%), 25 (83.3%), 30 (100%), respectively. The occurrence of manifestation of focal nodules or masses, dilated main pancreatic ducts, SPH, and accompanying cholelithiasis were significantly different (P=0.000) between T-AP and NT-AP groups. While, the differences in enhancement pattern and the occurrence of lymphadenosis between the two groups were not significant (P > 0.05). Conclusion The image features of T-AP are various. The application of CT and MRI could provide effective diagnostic guidelines for patients with T-AP.

Citation： YANGFan, CHENWei-xia. Image Comparative Analysis of Tumorous Acute Pancreatitis and Non-Tumorous Acute Pancreatitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(10): 1265-1269. doi: 10.7507/1007-9424.20150329 Copy

1.	Papachristou GI, Topazian M. Idiopathic recurrent pancreatitis:an EUS-based management approach. Gastrointest Endosc, 2011, 73(6):1155-1157.
2.	Retter J, Dinter D, Bersch C, et al. Acute recurrent pancreatitis curtaining an intraductal papillary mucinous tumor of the pancreas. J Gastrointestin Liver Dis, 2007, 16(4):445-447.
3.	Paramhans D, Shukla S, Mathur RK, et al. Large mucinous adenoma of pancreas presenting with recurrent pancreatitis. Turk J Gastroenterol, 2011, 22(1):98-100.
4.	Tonsi AF, Bacchion M, Crippa S, et al. Acute pancreatitis at the beginning of the 21st century:the state of the art. World J Gastroenterol, 2009, 15(24):2945-2959.
5.	李明欣, 尚东, 徐贺, 等.首发症状为急慢性胰腺炎的胰腺癌诊断与治疗.中华消化外科杂志, 2014, 13(11):859-863.
6.	Mujica VR, Barkin JS, Go VL, et al. Acute pancreatitis secondary to pancreatic carcinoma. Pancreas, 2000, 21(4):329-332.
7.	Brugge WR. Diagnosis and management of relapsing pancreatitis associated with cystic neoplasms of the pancreas. World J Gastroenterol, 2008, 14(7):1038-1043.
8.	Carbonetti F, Iannicelli E, Federici M, et al. Primary pancreatic burkitt lymphoma presenting as acute pancreatitis. J Gastrointest Cancer, 2014, 45 Suppl 1:265-269.
9.	O'Reilly DA, Kingsnorth AN. A brief history of pancreatitis. J R Soc Med, 2001, 94(3):130-132.
10.	Aimoto T, Uchida E, Nakamura Y, et al. Multicentric pancreatic intraepithelial neoplasias (PanINs) presenting with the clinical features of chronic pancreatitis. J Hepatobiliary Pancreat Surg, 2008, 15(5):549-553.
11.	Yamaguchi K, Tanaka M; Committee for Revision of Clinical Guidelines for Pancreatic Cancer of Japan Pancreas Society. EBMbased Clinical Guidelines for Pancreatic Cancer 2009 from the Japan Pancreas Society:a synopsis. Jpn J Clin Oncol, 2011, 41(7):836-840.
12.	Opie EL. The etiology of acute hemorrhagic pancreatitis. Johns Hopks Hosp Bull, 1901, 12:182-188.
13.	Kosmahl M, Pauser U, Peters K, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features:a review of 418 cases and a classification proposal. Virchows Arch, 2004, 445(2):168-178.
14.	Lee LY, Hsu HL, Chen HM, et al. Ductal adenocarcinoma of the pancreas with huge cystic degeneration:a lesion to be distinguished from pseudocyst and mucinous cystadenocarcinoma. Int J Surg Pathol, 2003, 11(3):235-239.
15.	Kaplan JO, Isikoff MB, Barkin J, et al. Necrotic carcinoma of the pancreas:"the pseudo-pseudocyst". J Comput Assist Tomogr, 1980, 4(2):166-167.
16.	Otani T, Atomi Y, Hosoi Y, et al. Extensive invasion of a ductal adenocarcinoma into the wall of a pancreatic pseudocyst. Pancreas, 1996, 12(4):416-419.
17.	Lu DS, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer:criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR Am J Roentgenol, 1997, 168(6):1439-1443.
18.	Gabata T, Matsui O, Kadoya M, et al. Small pancreatic adenocarcinomas:efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology, 1994, 193(3):683-688.

1. Papachristou GI, Topazian M. Idiopathic recurrent pancreatitis:an EUS-based management approach. Gastrointest Endosc, 2011, 73(6):1155-1157.
2. Retter J, Dinter D, Bersch C, et al. Acute recurrent pancreatitis curtaining an intraductal papillary mucinous tumor of the pancreas. J Gastrointestin Liver Dis, 2007, 16(4):445-447.
3. Paramhans D, Shukla S, Mathur RK, et al. Large mucinous adenoma of pancreas presenting with recurrent pancreatitis. Turk J Gastroenterol, 2011, 22(1):98-100.
4. Tonsi AF, Bacchion M, Crippa S, et al. Acute pancreatitis at the beginning of the 21st century:the state of the art. World J Gastroenterol, 2009, 15(24):2945-2959.
5. 李明欣, 尚东, 徐贺, 等.首发症状为急慢性胰腺炎的胰腺癌诊断与治疗.中华消化外科杂志, 2014, 13(11):859-863.
6. Mujica VR, Barkin JS, Go VL, et al. Acute pancreatitis secondary to pancreatic carcinoma. Pancreas, 2000, 21(4):329-332.
7. Brugge WR. Diagnosis and management of relapsing pancreatitis associated with cystic neoplasms of the pancreas. World J Gastroenterol, 2008, 14(7):1038-1043.
8. Carbonetti F, Iannicelli E, Federici M, et al. Primary pancreatic burkitt lymphoma presenting as acute pancreatitis. J Gastrointest Cancer, 2014, 45 Suppl 1:265-269.
9. O'Reilly DA, Kingsnorth AN. A brief history of pancreatitis. J R Soc Med, 2001, 94(3):130-132.
10. Aimoto T, Uchida E, Nakamura Y, et al. Multicentric pancreatic intraepithelial neoplasias (PanINs) presenting with the clinical features of chronic pancreatitis. J Hepatobiliary Pancreat Surg, 2008, 15(5):549-553.
11. Yamaguchi K, Tanaka M; Committee for Revision of Clinical Guidelines for Pancreatic Cancer of Japan Pancreas Society. EBMbased Clinical Guidelines for Pancreatic Cancer 2009 from the Japan Pancreas Society:a synopsis. Jpn J Clin Oncol, 2011, 41(7):836-840.
12. Opie EL. The etiology of acute hemorrhagic pancreatitis. Johns Hopks Hosp Bull, 1901, 12:182-188.
13. Kosmahl M, Pauser U, Peters K, et al. Cystic neoplasms of the pancreas and tumor-like lesions with cystic features:a review of 418 cases and a classification proposal. Virchows Arch, 2004, 445(2):168-178.
14. Lee LY, Hsu HL, Chen HM, et al. Ductal adenocarcinoma of the pancreas with huge cystic degeneration:a lesion to be distinguished from pseudocyst and mucinous cystadenocarcinoma. Int J Surg Pathol, 2003, 11(3):235-239.
15. Kaplan JO, Isikoff MB, Barkin J, et al. Necrotic carcinoma of the pancreas:"the pseudo-pseudocyst". J Comput Assist Tomogr, 1980, 4(2):166-167.
16. Otani T, Atomi Y, Hosoi Y, et al. Extensive invasion of a ductal adenocarcinoma into the wall of a pancreatic pseudocyst. Pancreas, 1996, 12(4):416-419.
17. Lu DS, Reber HA, Krasny RM, et al. Local staging of pancreatic cancer:criteria for unresectability of major vessels as revealed by pancreatic-phase, thin-section helical CT. AJR Am J Roentgenol, 1997, 168(6):1439-1443.
18. Gabata T, Matsui O, Kadoya M, et al. Small pancreatic adenocarcinomas:efficacy of MR imaging with fat suppression and gadolinium enhancement. Radiology, 1994, 193(3):683-688.

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Image Comparative Analysis of Tumorous Acute Pancreatitis and Non-Tumorous Acute Pancreatitis

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