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Erschienen in:
21.09.2016 | Hepatobiliary-Pancreas
Fate of small pancreatic cysts (<3 cm) after long-term follow-up: analysis of significant radiologic characteristics and proposal of follow-up strategies
Erschienen in: European Radiology | Ausgabe 6/2017
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Objective
To describe the natural history of pancreatic cysts after long-term follow-up, with an emphasis on the identifying indicators of indolent lesions.
Methods
We retrospectively sampled 95 patients with 149 cysts <3 cm detected by CT from 2003 to 2004, and followed them for more than five years (mean 117.5 ± 18.8 months). Two radiologists reviewed the initial CT images, then recorded changes after the follow-up. We compared the cysts’ initial characteristics between the surgery and non-surgery patient groups, and also between non-benign lesions and benign lesions.
Results
Twelve of the 95 patients, who among them had 16 cysts, underwent surgery. Of the 133 cysts in the 83 nonsurgical patients, 57 cysts (42.9 %) enlarged, although only five cysts increased to larger than 3 cm at the end of observation. The initial size of the cyst was significantly larger in the surgery group than non-surgery group. Also, according to cyst-based analysis, ductal communication, dilatation, and shape correlated with those of non-benign cysts and the non-surgical group. No cysts < 15 mm and without p-duct change showed a significant change within three years.
Conclusion
Small pancreatic cysts, without p-duct change, and without a pleomorphic or clubbed shape, may be followed for a longer interval than current consensus.
Key Points
• Almost all small cysts < 3 cm were indolent in long term observation.
• No cysts < 15 mm, without p-duct change showed significant change within 3 years.
• Cyst size, ductal change and shape can be useful in predicting progress.
• Only cysts with IPMN- like features and p-duct change need follow-up with cautions.