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MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance

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Abstract

Objective

The purpose of the study was to investigate the incidence of pancreatic contour variations on multidetector CT (MDCT) for abdominal examinations.

Methods

A retrospective analysis of 700 MDCT scans was performed in patients who underwent triple phase CT abdomen between October 2018 and January 2021. After excluding 176 patients, finally total of 524 patients were included in the study. For simplification, we classified the pancreatic contour variations as classified by Ross et al. and Omeri et al. Pancreatic head–neck variations was classified into Type I-anterior, Type II-posterior and Type III-horizontal variety. Pancreatic body–tail variation was divided into Type Ia-anterior projection; Ib-posterior projection and Type IIa-globular, IIb-lobulated, IIc-tapered, and IId-bifid pancreatic tail.

Results

The most common type of variation in the head was Type II (n = 112, 21.3%) followed by Type III (n = 37, 7%) and Type I (n = 21, 4%). The most common type of variation in the body of pancreas was Type Ia (n = 33, 6.2%) followed by Type Ib (n = 13, 2.4%). In the tail region of pancreas, the most common variation was Type IIb (n = 21, 4%) followed by Type IIa (n = 19, 3.6%).

Conclusion

Pancreatic contour variations are not very uncommon in daily practice. Knowledge of these variations is important for surgeons, radiologists and avoids misjudgement of normal pancreatic tissue as tumor or lymph node especially on unenhanced or single phase MDCT.

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Acknowledgements

To Departments of General Surgery, Surgical Oncology and Surgical Gastroenterology

Funding

No funding was received for this study.

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Author notes

  1. Arushi Yadav

    Present address: Department of Radiodiagnosis, GMC Chandigarh, Chandigarh, India

Authors and Affiliations

  1. Department of Diagnostic & Interventional Radiology, AIIMS, Jodhpur, 342005, India

    Binit Sureka, Satya Jha, Arushi Yadav, Taruna Yadav, Pawan Kumar Garg & Pushpinder Singh Khera

  2. Department of Surgical Gastroenterology, AIIMS, Jodhpur, India

    Vaibhav Varshney & Subhash Soni

  3. Department of Surgical Oncology, AIIMS, Jodhpur, India

    Jeewan Ram Vishnoi & Sanjeev Misra

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  1. Binit Sureka
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Contributions

BS made the project design and development, Manuscript writing, Data collection, SJ and AY did data collection, VV, SV and JV did data editing, referred cases for imaging, TY and PKG did manuscript editing, statistics and data editing, PK did protocol development and SM did final manuscript editing.

Corresponding author

Correspondence to Binit Sureka.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from individual participant included in the study.

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Sureka, B., Jha, S., Yadav, A. et al. MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance. Surg Radiol Anat 43, 1405–1412 (2021). https://doi.org/10.1007/s00276-021-02735-4

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  • DOI: https://doi.org/10.1007/s00276-021-02735-4

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