Application Of Multi-slice CT Post-processing Techniques In The Diagnosis Of Intraductal Papillary Mucinous Neoplasm Of The Pancreas

ObjectiveTo explore the value of MSCTpost-processing techniques in diagnosis of intraductalpapillary mucinous neoplasm(IPMN).Materials and MethodsRetrospective analysis 18 cases of IPMNconfirmed by pathology, with clinical and imaging (from Jan.2011 to May.2013). Using MPR, MinIP, and CPRtechniques, to postprocess the original image of MSCT, and evaluate each of post-processing technique’s capability of displaying pancreatic lesions. Scoring criterias are as follows: ①he ability ofdisplayingthe lesion(including the parenchyma cystic or solid, the contour and the extent of the lesion):clearly displayed as 2 points, fuzzy displayed as 1 point, cannot bedisplayed as 0 point;②The relationship between dilated pancreatic duct and lesions:clearly displayed as 2 points, fuzzy displayed as 1 point, cannot be displayed as 0 point; ③The relationship of the lesionwithsurroundingstructures: clearly displayed as 2 points, fuzzy displayed as 1 point, cannot be displayed as 0 point.ResultsThe accuracyratethat preoperative diagnosisof IPMN with MSCT, is 88.8%(16/18, 88.8%).2 cases were misdiagnosed as cystadenoma in 18 cases of IPMN. Histopathologic confirmed that IPMN with mild to moderate atypical hyperplasia in 9 cases (9/18 and 50.0%), IPMN with severe atypical hyperplasia in 7 cases (7/18, 38.9%), IPMN with invasive carcinoma in 2 cases, which including 1 case (1/18, 5.6%) MD-IPMN,1 case (1/18,5.6%) MT-IPMN.There were 9 cases (9/18,50%) withthe main pancreatic duct dilatation. Among them, main pancreatic duct diameter ≥1 cm in 7 cases (38.9.38.89%),0.3-1.0cm in2 cases (2/18,11%).Type of MD-IPMN in 6 cases (6/18,33.3%), BD-IPMN in 9 cases (9/18,50%), and MT-IPMN in 3 cases (3/18,16.7%).Scores ofMPRwere 35and 31 points,respectively,in the ability to display the lesion itself and relationship with the surrounding structures, which washigher than that ofMinIP (29 pointsand 20 points) and CPR (24 points and 18 points). Scores ofMinIPwere 32 points in the ability to display the relationship between the lesion and dilated pancreatic duct, which was higher thanthat of MPR (28 points) and CPR (21 points). The totalscoresof CPR (63points)were lower than that of MPR (94points) and MinIP (81points).The scores of display ability have significant differenceamongthree post-processing techniques,confirmed byKruskal-Walls rank-sum test(p<0.05). Except no significant difference between the MinIP and CPR groups in displaying the relationship between the lesions and the surrounding structures (p=0.157), there were significant differences among the other groups by Wilcoxon rank-sum test.ConclusionCombined application of MSCT post-processing techniques, the reconstructive images can provide accurate information about the lesions, dilated pancreatic duct and the surrounding structures integrally that has important value in diagnosis of IPMN, and that will be helpful to the clinical treatment plan and follow-up.