MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP) VERSUS ENDOSONOGRAPHY-GUIDED FINE NEEDLE ASPIRATION (EUS-FNA) FOR DIAGNOSIS AND FOLLOW-UP OF PANCREATIC INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS

Autor: Débora Azeredo Pacheco Dias Costa, Paulo Afonso Nunes Nassif, Jurandir Marcondes Ribas-Filho, Carmen Australia Paredes Marcondes Ribas, Rafael Kemp, Joao Guilherme Guerra, Suzan Menasce Goldman, José Sebastião dos Santos, José Celso Ardengh
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Adolescent
Pancreatic neoplasms
RD1-811
Cholangiopancreatography
Magnetic Resonance
medicine.medical_treatment
Pancreatic Intraductal Neoplasms
Pancreatic Intraepithelial Neoplasia
RC799-869
Sensitivity and Specificity
Surgical pathology
Young Adult
Laparotomy
medicine
Humans
Colangiopancreatografia por ressonância magnética
Child
Pathological
Aged
Aged
80 and over
Endoscopic ultrasound-guided fine needle aspiration
Magnetic resonance cholangiopancreatography
medicine.diagnostic_test
business.industry
Diagnóstico
Magnetic resonance imaging
General Medicine
Middle Aged
Diseases of the digestive system. Gastroenterology
medicine.disease
Fine-needle aspiration
Female
Original Article
Surgery
Mucinous Tumor
Radiology
Aspiração por agulha fina guiada por ultrassom endoscópico
business
Follow-Up Studies
Zdroj: ABCD: Arquivos Brasileiros de Cirurgia Digestiva
Arquivos Brasileiros de Cirurgia Digestiva : ABCD
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.32 n.4 2019
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Colégio Brasileiro de Cirurgia Digestiva (CBCD)
instacron:CBCD
ISSN: 2317-6326
0102-6720
DOI: 10.1590/0102-672020190001e1471
Popis: Background: Intraductal papillary mucinous tumor (IPMN) are being diagnosed with increasing frequency. Computerized tomography scanning is commonly used as the primary imaging modality before surgery nonetheless magnetic resonance cholangiopancreatography (MRCP) provides better characterization. Endosonography-guided fine needle aspiration (EUS-FNA) has emerged as a way to reach pathological diagnose. Aim: To compare results of both methods with surgical pathology findings for classification of IPMN. Methods: Thirty-six patients submitted to surgical resection with preoperative suspect of IPMN were submitted preoperatively to MRCP and EUS-FNA. Images obtained were analyzed according to a classification determined for each method. ROC curve was used for statistical analysis, that compared the images tests with the purpose of finding the best method for diagnosis and classification of IPMN. Results: Sixteen patients underwent pancreatoduodenectomy, 16 to subtotal pancreatectomy and only four laparotomy. Pathological diagnosis was IPMN (n=33) and pancreatic intraepithelial neoplasia type 2 (n=3). Twenty-nine revealed non-invasive neoplasia and invasive form in four patients. MRCP and EUS-FNA have correctly diagnosed and classified (type of IPMN), in 62.5% and 83.3% (p=0.811), the affected segment location in 69% and 92% (p=0.638) and identification of nodules and/or vegetation presence in 45% and 90% (p=0.5). Regarding to histopathological diagnosis by EUS-FNA the sensitivity was 83.3%; specificity was 100%; positive predictive value was 100%; negative predictive value was 33.3% and accuracy was 91.7%. Conclusions: There was no significant difference in the diagnosis of IPMN. However, EUS-FNA showed better absolute results than MRCP to identify nodule and/or vegetation.
Databáze: OpenAIRE
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