J Korean Soc Radiol.  2015 Jun;72(6):373-380. 10.3348/jksr.2015.72.6.373.

Comparative Diagnostic Performance of Multidetector Computed Tomography and MRI for Characterization of Pancreatic Cystic Lesions

• Moon SM
• Jeong YY
• Shin SS
• Park JG

• KMID: 2098015
• DOI: http://doi.org/10.3348/jksr.2015.72.6.373

Abstract

PURPOSE
To compare the diagnostic performance of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in characterization of pancreatic cystic lesions.
MATERIALS AND METHODS
We conducted a retrospective study on 34 patients with histopathologically proven cystic pancreatic lesions who underwent both preoperative MDCT and MRI. CT and MRI were independently evaluated for differentiating mucinous vs. non-mucinous lesions, differentiating aggressive vs. non-aggressive lesion, analyzing morphological features, and evaluating specific leading diagnoses. Sensitivity, specificity, and accuracy were determined. Competency assessment of lesional morphology analysis was performed using the kappa values of the 2 tests.
RESULTS
The sensitivity, specificity, and accuracy of MRI for differentiating mucinous vs. non-mucinous lesions were higher than CT (p = 0.03). For differentiating aggressiveness, the sensitivity of MRI was better than CT, but the specificity of CT was better than MRI. In evaluation of morphologic features, MRI showed better performance in characterization of septa and wall. Otherwise, the 2 modalities showed similarly good performance. MRI was better than CT in determining a specific diagnosis (58.8% vs. 47.2%, respectively).
CONCLUSION
CT and MRI are reasonable diagnostic methods for characterization of pancreatic cystic lesions. However, MRI enables more confident assessment than CT in differentiating mucinous vs. non-mucinous lesions and characterization of the septa and wall.

MeSH Terms

Diagnosis
Humans
Magnetic Resonance Imaging*
Mucins
Multidetector Computed Tomography*
Pancreas
Pancreatic Cyst*
Retrospective Studies
Sensitivity and Specificity
Mucins

Figure

• 

  Fig. 1 A 59-year-old male with serous cystadenoma in body of pancreas. A, B. Axial and coronal reformatted contrast enhanced multidetector CT image reveals unilocular cystic lesion (arrow) with no definite septations. This lesion was misdiagnosed as pseudocyst. C, D. Axial and coronal T2-weighted MR image reveals multilocular cystic lesion (arrow) with obvious intralesional septa.

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