MRI diagnosis pancreas cystics neoplasms at the stages of a medical examination

DOI: https://doi.org/10.29296/25877305-2022-11-07
Issue: 
11
Year: 
2022

S. Skulskiy(1, 2), Candidate of Medical Sciences; Professor V. Ratnikov(2, 3), MD; Professor Ya. Lubashev(1), MD; E. Sevryukova(1), Candidate of Medical Sciences
1-ICDC of PAO «Gazprom», Moscow
2-L.G. Sokolov North-Western district scientific and clinical center, Federal Medical and Biological Agency, Saint Petersburg
3-Saint Petersburg State University

The use of modern imaging techniques in clinical practice is accompanied by a steady increase in the detection of pancreatic cystic neoplasms, many of which are an accidental finding due to asymptomatic course. At the same time, the absence of early clinical manifestations in conjunction with the different malignant potential of cystic neoplasia of the pancreas, the difficulties of differential diagnosis, determine the extreme relevance of this clinical problem. Purpose of the study. To evaluate the possibilities and advantages of magnetic resonance imaging (MRI) in the differential diagnosis of pancreatic cystic neoplasms. Materials and methods. The analysis of clinical and radiographic data of 75 patients with cystic neoplasms of the pancreas was carried out. All patients underwent MRI, in the amount or combination of the MR-protocol, magnetic resonance diffusion, magnetic resonance cholangiopancreatography, dynamic contrast enhancement. Computed tomography (n=7), endosonography (n=45) were also performed. Results and conclusions. Tissue contrast, the use of various modalities of magnetic resonance imaging provides a number of advantages in the visualization of cystic neoplasms of the pancreas and the assessment of relationships with the ductal system, which allows us to consider it as the most effective method in the algorithm for radiological diagnosis of cystic neoplasms of the pancreas. During the study, the sensitivity of MRI in the diagnosis of cystic neoplasms was 96%, the specificity was 90%. The most frequent cystic neoplasms were intraductal papillary mucinous neoplasm type II – 34.5%. Serous cystic neoplasm (16%), mucinous cystic neoplasm (12%), and intraductal papillary mucinous neoplasm type I (10.5%) were also identified. Timely use of MRI at the stages of primary and differential diagnosis of cystic neoplasms of the pancreas will allow not only the necessary surgical treatment, but also to avoid unreasonable intervention. MRI is the method of choice for non-invasive differential diagnosis of pancreatic cystic neoplasms and the method of their dynamic monitoring.
Keywords: 
magnetic resonance imaging
mucinous cystic neoplasm
intraductal papillary mucinous neoplasm
endosonography

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