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CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs)

  • Gastrointestinal
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Abstract

Objectives

To describe CT and MR imaging findings of acinar cell cystadenoma (ACC) of the pancreas and to compare them with those of branch duct intraductal papillary mucinous neoplasia (BD-IPMN) to identify distinctive elements.

Methods

Five patients with ACC and the 20 consecutive patients with histologically proven BD-IPMN were retrospectively included. Clinical and biological information was collected and histological data reviewed. CT and MR findings were analysed blinded to pathological diagnosis in order to identify imaging diagnostic criteria of ACC.

Results

Patients with ACC were symptomatic in all but one case and were younger than those with BD-IPMN (p = 0.006). Four radiological criteria allowed for differentiating ACC from IPMN: five or more cysts, clustered peripheral small cysts, presence of cyst calcifications and absence of communication with the main pancreatic duct (p < 0.05). Presence of at least two or three of these imaging criteria had a strong diagnostic value for ACC with a sensitivity of 100 % and 80 % and a specificity of 85 % and 100 %, respectively.

Conclusions

Preoperative differential diagnosis between ACC and BD-IPMN can be achieved using a combination of four CT and/or MR imaging criteria. Recognition of ACC patients could change patient management and lead to more conservative treatment.

Key Points

• Four imaging findings are associated with acinar cell cystadenoma (ACC).

• Imaging could achieve differential diagnosis between ACC and BD-IPMN.

• Diagnosis on imaging would change patient management and avoid surgical resection.

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Abbreviations

ACC:

Acinar cell cystadenoma

BD-IPMN:

Branch duct intraductal papillary mucinous neoplasia

MDCT:

Multidetector computed tomography

MRCP:

Magnetic resonance cholangiopancreatography

OR:

Odds ratio

PAS:

Periodic acid stain

SD:

Standard deviation

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Acknowledgements

The scientific guarantor of this publication is Professor Valérie Vilgrain. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective, case–control study, performed at one institution.

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Authors and Affiliations

  1. Service de Radiologie, Hôpital Beaujon, 100, Boulevard du Général Leclerc, 92118, Clichy Cedex, France

    Christophe Delavaud, Gaspard d’Assignies, Valérie Vilgrain & Marie-Pierre Vullierme

  2. Service d’Anatomopathologie, Hôpital Beaujon, 100, Boulevard du Général Leclerc, 92118, Clichy Cedex, France

    Jérome Cros

  3. Service de Pancréato-Gastro-Entérologie, Hôpital Beaujon, 100, Boulevard du Général Leclerc, 92118, Clichy Cedex, France

    Philippe Ruszniewski, Pascal Hammel & Philippe Levy

  4. Service d’Anatomopathologie, Hôpital Bichat, 46, Rue Henri Huchard, 75877, Paris Cedex 18, France

    Anne Couvelard

  5. Service de Chirurgie Hépato-Pancréato-Biliaire, Hôpital Beaujon, 100, Boulevard du Général Leclerc, 92118, Clichy Cedex, France

    Alain Sauvanet & Safi Dokmak

Authors
  1. Christophe Delavaud
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  2. Gaspard d’Assignies
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  3. Jérome Cros
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  4. Philippe Ruszniewski
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  5. Pascal Hammel
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  6. Philippe Levy
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  7. Anne Couvelard
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  8. Alain Sauvanet
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  9. Safi Dokmak
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  10. Valérie Vilgrain
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  11. Marie-Pierre Vullierme
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Correspondence to Christophe Delavaud.

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Delavaud, C., d’Assignies, G., Cros, J. et al. CT and MR imaging of multilocular acinar cell cystadenoma: comparison with branch duct intraductal papillary mucinous neoplasia (IPMNs). Eur Radiol 24, 2128–2136 (2014). https://doi.org/10.1007/s00330-014-3248-0

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  • DOI: https://doi.org/10.1007/s00330-014-3248-0

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