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  • Title: Macrocystic pancreatic lesions: differentiation of benign from premalignant and malignant cysts by CT.
    Author: Kim SH, Lim JH, Lee WJ, Lim HK.
    Journal: Eur J Radiol; 2009 Jul; 71(1):122-8. PubMed ID: 18448299.
    Abstract:
    OBJECTIVE: To assess useful CT features for differentiating benign from premalignant and malignant macrocystic pancreatic lesions. METHODS: Seventy-four patients with pathologically proven macrocystic pancreatic lesions were enrolled: 17 benign cysts (macrocystic serous cystadenoma, n=12; congenital cyst; n=5) and 57 premalignant and malignant cysts (mucinous cystic neoplasm, n=28; intraductal papillary mucinous neoplasm of branch duct type, n=20; tumor with cystic change, n=9). Size, location, shape (lobulated, round or oval, or complex cystic with tubular cyst), wall thickness (thin, < or =1mm; thick, >1mm), internal surface (smooth or irregular), and other findings were analyzed with multiphasic CT with thin-section (2.5-3mm) images. CT features between two groups were compared using univariate and multivariate stepwise logistic regression analyses. RESULTS: On univariate analysis, the differences for the shape (p=0.007), wall thickness (p=0.011), and internal surface (p=0.012) between benign and premalignant and malignant cysts were significant. A lobulated shape, a thin wall and a smooth internal surface were more frequent in benign cysts, whereas a round or oval shape or a complex cystic shape with tubular cyst, a thick wall and an irregular internal surface were more frequent in premalignant and malignant cysts. On multivariate analysis, the shape (p=0.002) and wall thickness (p=0.025) were significant CT features for differentiating benign from premalignant and malignant cysts. CONCLUSION: Shape and wall thickness are the main CT features for differentiating benign from premalignant and malignant macrocystic pancreatic lesions.
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