Anatomic variants of the pancreatic duct and their clinical relevance: an MR-guided study in the general population

作者：Buelow Robin; Simon Peter; Thiel Robert; Thamm Patrick; Messner Philip; Lerch Markus M; Mayerle Julia; Voelzke Henry; Hosten Norbert; Kuehn Jens Peter

来源：European Radiology, 2014, 24(12): 3142-3149.

DOI：10.1007/s00330-014-3359-7

• Pancreas divisum
• Pancreatic duct variants
• Magnetic resonance imaging
• Cholangiopancreatography
• Chronic pancreatitis

To investigate the frequency of pancreatic duct (PD) variants and their effect on pancreatic exocrine function in a population-based study using non-invasive secretin-stimulated magnetic resonance cholangiopancreatography (sMRCP). %26lt;br%26gt;Nine hundred and ninety-five volunteers, 457 women and 538 men, aged 51.9 +/- 13.4 years, underwent navigator-triggered, T2-weighted, 3D turbo spin echo MRCP on a 1.5 T system after 1 unit/kg secretin administration. Two readers evaluated images for PD variants. Pancreatic exocrine function and morphological signs of chronic pancreatitis such as abnormalities of the main PD, side branch dilatation, and pancreatic cysts were evaluated and related to PD variants using a Kruskal-Wallis test and post hoc analysis. %26lt;br%26gt;Of all sMRCP, 93.2 % were of diagnostic quality. Interobserver reliability for detection of PD variants was found to be kappa 0.752 (95 %CI, 0.733 - 0.771). Normal PD variants were observed in 90.4 % (n = 838/927). Variants of pancreas divisum was identified in 9.6 % (n = 89/927). Abnormalities of the main PD, side branch dilatation, and pancreatic cysts were observed in 2.4 %, 16.6 %, and 27.7 %, respectively, and were not significantly different between pancreas divisum and non-divisum group (P = 0.122; P = 0.152; P = 0.741). There was no association between PD variants and pancreatic exocrine P = 0.367). %26lt;br%26gt;PD variants including pancreas divisum are not associated with morphological signs of chronic pancreatitis or restriction of pancreatic exocrine function. %26lt;br%26gt;aEuro cent MRCP allows the evaluation of pancreatic duct variants and morphological change. %26lt;br%26gt;aEuro cent Pancreatic duct variants are not associated with morphological signs of chronic pancreatitis. %26lt;br%26gt;aEuro cent Pancreas divisum is not accompanied by restriction of pancreatic exocrine function. %26lt;br%26gt;aEuro cent Pancreatic duct variants including pancreas divisum are limited in their clinical relevance.

• 出版日期2014-12