La radiologia medica

, Volume 117, Issue 8, pp 1275–1286 | Cite as

Bull’s-eye pattern of pancreatic-duct stones on multidetector computed tomography and gene-mutation-associated pancreatitis (GMAP)

  • R. Graziani
  • L. Frulloni
  • C. Cicero
  • R. Manfredi
  • M. C. Ambrosetti
  • S. Mautone
  • R. Pozzi Mucelli
Abdominal Radiology / Radiologia Addominale

Abstract

Purpose

This study prospectively assessed whether the presence of a bull’s-eye pattern of pancreatic-duct stones on multidetector computed tomography (MDCT) correlated with gene-mutation-associated pancreatitis (GMAP) and whether other signs suggestive of GMAP can be detected with MDCT.

Materials and methods

Forty-seven patients with chronic calcific pancreatitis underwent genetic testing for CFTR, SPINK1 and PRSS1 mutations and an MDCT scan of the abdomen. Qualitative analysis assessed the presence or absence of pancreatic-duct stones with bull’s-eye appearance. Quantitative analysis included the number and maximum diameter of stones and the diameter of the main pancreatic duct.

Results

Fifteen of 47 patients (32%) were positive for gene mutations (GMAP patients). The bull’s-eye pattern was found in 10/15 patients (67%) with GMAP and in 4/32 (12%) patients with chronic pancreatitis not associated with GMAP (NGMAP; p<0.0001). The mean diameter of duct stones was 15 mm in patients with GMAP and 10 mm in patients with NGMAP (p<0.04).

Conclusions

The presence of duct stones with a bull’s-eye pattern correlates with GMAP. Duct stones with diameter ≥15 mm are another sign suggestive of GMAP.

Keywords

Chronic pancreatitis Gene mutations Pancreatic stones Multidetector computed tomography Bull’s-eye pattern 

Il pattern TC multidetettore dei calcoli duttali pancreatici a “bull’s eye” e pancreatite cronica associata a mutazione genetica (GMAP)

Riassunto

Obiettivo

Valutare prospettivamente se la presenza alla tomografia computerizzata multidetettore (TCMD) di calcoli pancreatici con pattern a “bull’s eye” si correli alla pancreatite associata a mutazione genetica (GMAP) e se vi siano altre caratteristiche TCMD suggestive nei pazienti affetti da GMAP.

Materiali e metodi

Quarantasette pazienti con pancreatite cronica calcifica sono stati sottoposti a test genetici per le mutazioni di CFTR, SPINK1 e PRSS1 ed esame TCMD dell’addome. L’analisi qualitativa ha riguardato la presenza o assenza di calcoli duttali pancreatici con morfologia a “bull’s eye”. L’analisi quantitativa ha incluso: numero e massimo diametro dei calcoli duttali; diametro del dotto pancreatico principale.

Risultati

Quindici pazienti su 47 (32%) sono risultati positivi per la presenza di mutazioni genetiche (pazienti GMAP). Il pattern a “bull’s eye” è stato rilevato in 10/15 pazienti (67%) con GMAP e in 4/32 (12%) pazienti con pancreatite cronica non associata a mutazione genetica (NGMAP: p<0,0001). Il diametro medio dei calcoli duttali è stato di 15 mm nei pazienti con GMAP e 10 mm nei pazienti con NGMAP (p<0,04).

Conclusioni

La presenza di calcoli duttali con pattern a “bull’s eye”si correla alle GMAP. Anche calcoli duttali con diametro ≥15 mm sono un segno correlato alle GMAP.

Parole chiave

Pancreatite cronica Mutazioni genetiche Calcoli pancreatici Tomografia Computerizzata Multidetettore Pattern a “bull’s eye” 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • R. Graziani
    • 1
  • L. Frulloni
    • 2
  • C. Cicero
    • 1
  • R. Manfredi
    • 1
  • M. C. Ambrosetti
    • 1
  • S. Mautone
    • 1
  • R. Pozzi Mucelli
    • 1
  1. 1.Istituto di RadiologiaUniversità di VeronaVeronaItaly
  2. 2.GastroenterologiaUniversità di VeronaVeronaItaly

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