Application of computed tomography in evaluating imaging features of intraductal papillary mucinous neoplasms
Tóm tắt
Introduction:
Intraductal papillary mucinous neoplasms (IPMNs) are increasingly detected owing to high-resolution imaging. IPMNs have malignant potential, ranging from low-grade dysplasia to invasive carcinoma. However, data from Vietnam are limited. This study aimed to describe computed tomography (CT) features of IPMNs and evaluate their diagnostic value.
Methods:
We performed a retrospective case series of patients with histopathologically confirmed IPMNs between January 2016 and December 2024. Thirty-two patients who underwent preoperative CT scans and met inclusion criteria were analyzed. CT features were assessed for their association with malignancy.
Results:
The cohort comprised 32 patients from 17 malignant and 15 benign cases. The mean age was 64.5±10.2 years of 19 men, 13 women. CT features significantly associated with malignancy were enhancing mural nodules (p<0.001), main pancreatic duct diameter (p=0.047), cyst size (p=0.047), thickened enhancing cyst walls (p=0.031), abrupt ductal caliber change with distal atrophy (p=0.026), and lymphadenopathy (p=0.019). Mural nodules≥5 mm demonstrated high sensitivity and specificity (82.4% and 80%). When patients had ≥4 worrisome features, the corresponding sensitivity (82.4%), specificity (80%), and accuracy (81.3%) in this small surgical series should be interpreted as descriptive, hypothesis-generating estimates rather than as definitive values or as directly comparable to those of high-risk stigmata.
Conclusions:
CT provides valuable information for not only diagnosing IPMNs but also predicting malignant potential. Mural nodules ≥5 mm and accumulation of worrisome features can help identify patients who may benefit from surgical intervention.
