Abstract:
OBJECTIVES:There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS:For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. RESULTS:The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P < 0.001 for each). On review by expert radiologists, the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (κ = 0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (κ = 0.43). CONCLUSIONS:Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.
journal_name
Pancreasjournal_title
Pancreasauthors
Kushnir VM,Wani SB,Fowler K,Menias C,Varma R,Narra V,Hovis C,Murad FM,Mullady DK,Jonnalagadda SS,Early DS,Edmundowicz SA,Azar RRdoi
10.1097/MPA.0b013e31826c711asubject
Has Abstractpub_date
2013-04-01 00:00:00pages
436-41issue
3eissn
0885-3177issn
1536-4828journal_volume
42pub_type
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