Diagnostic performance of MRI and EUS in the differentiation of benign from malignant pancreatic cyst and cyst communication with the main duct

作者：Kim Jung Hoon^*; Eun Hyo Won; Park Hyun Jeong; Hong Seong Sook; Kim Young Jae

来源：European Journal of Radiology, 2012, 81(11): 2927-2935.

DOI：10.1016/j.ejrad.2011.12.019

• MRI
• EUS
• Pancreas
• Cyst
• Neoplasm
• Pancreatic duct

Purpose: To assess the diagnostic ability of MRI and EUS for differentiating benign from malignant pancreatic cyst focusing on cyst communication with pancreatic duct. %26lt;br%26gt;Materials and methods: During 44 months, we performed MRI on 65 pancreatic cysts. Among them, 36 patients had confirmed cyst communication with duct by ERCP or surgery and 39 patients underwent EUS. Fifty-one had proven by surgery or aspiration. Among them, 36 had confirmed malignant cysts. Two radiologists independently graded cyst communication with duct and the likelihood of malignancy. When the readers%26apos; interpretations differed, third opinion was obtained. They also measured the size of cyst and main duct. The diagnostic performance was analyzed using the ROC curve. The Mann-Whitney U test and kappa statistics were used to determine interobserver agreement. %26lt;br%26gt;Results: The Az of MRI and EUS for determining diagnostic performance regarding the cyst communication with duct, were 0.931 and 0.930, without statistically difference (p = 0.6). Interobserver agreement was excellent (kappa = 0.81) on MRI and substantial (kappa = 0.69) on EUS. The Az of MRI and EUS for assessing diagnostic performance to differentiate malignant from benign cyst, was 0.902 and 0.923, without statistically difference (p = 0.587). Interobserver agreement was excellent (kappa = 0.81) on MRI and moderate (kappa = 0.47) on EUS. The mean cyst size (3.98 cm + 2.74: 3.17 cm + 1.26, p = 0.327) and the duct size (5.20 mm + 3.22: 4.39 mm + 4.12, p = 0.227) showed no statistically difference between malignant and benign cysts. %26lt;br%26gt;Conclusion: MRI and EUS can accurately assess pancreatic cyst communication with duct and are very useful for obtaining a differential diagnosis of malignant cyst versus benign pancreatic cyst.

• 出版日期2012-11