TY - JOUR
T1 - Dual-phase CT of autoimmune pancreatitis
T2 - A multireader study
AU - Takahashi, Naoki
AU - Fletcher, Joel G.
AU - Fidler, Jeff L.
AU - Hough, David M.
AU - Kawashima, Akira
AU - Chari, Suresh T.
PY - 2008/2/1
Y1 - 2008/2/1
N2 - OBJECTIVE. The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT. MATERIALS AND METHODS. Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics. RESULTS. Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, κ = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, κ = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, κ = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, κ = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, κ = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, κ = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, κ = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, κ = 0.60-0.65) were more frequent in patients with carcinoma. CONCLUSION. Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis.
AB - OBJECTIVE. The purpose of this study was to identify findings that aid in differentiating autoimmune pancreatitis from pancreatic carcinoma using dual-phase CT. MATERIALS AND METHODS. Dual-phase CT scans of 74 patients (25 with autoimmune pancreatitis, 33 with pancreatic carcinoma, and 16 with a normal pancreas) were independently evaluated by three radiologists for enhancement of the pancreas; the presence of a capsule-like rim, peripancreatic strands, and pancreatic calcifications; pancreatic duct or bile duct changes; and renal involvement. The frequency of CT characteristics was compared between autoimmune pancreatitis and carcinoma. Interobserver agreement for the three reviewers for the assessment of CT characteristics was evaluated using kappa statistics. RESULTS. Diffusely decreased enhancement of the pancreas (autoimmune pancreatitis vs carcinoma: 28% vs 3%; p = 0.02, κ = 0.33-0.75), capsule-like rim (40% vs 9%; p = 0.009, κ = 0.42-0.66), peripancreatic strands (60% vs 27%; p = 0.02, κ = 0.45-0.54), pancreatic calcifications (32% vs 9%; p = 0.04, κ = 0.14-0.47), bile duct wall enhancement (52% vs 6%; p = 0.0001, κ = 0.28-0.47), and renal involvement (28% vs 0%; p = 0.002, κ = 0.32-0.74) were more frequent in patients with autoimmune pancreatitis. Pancreatic duct dilation (24% vs 67%; p = 0.001, κ = 0.65-0.73) and abrupt cutoff (16% vs 55%; p = 0.003, κ = 0.60-0.65) were more frequent in patients with carcinoma. CONCLUSION. Diffusely decreased enhancement of the pancreas, a capsule-like rim, bile duct enhancement, and renal involvement are useful signs of autoimmune pancreatitis.
KW - Autoimmune pancreatitis
KW - CT
KW - Gastrointestinal tract
KW - Pancreas
KW - Pancreatic carcinoma
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U2 - 10.2214/AJR.07.2309
DO - 10.2214/AJR.07.2309
M3 - Article
C2 - 18212210
AN - SCOPUS:38849110189
SN - 0361-803X
VL - 190
SP - 280
EP - 286
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
IS - 2
ER -