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18.03.2021 | Original Article

MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance

verfasst von: Binit Sureka, Satya Jha, Arushi Yadav, Vaibhav Varshney, Subhash Soni, Jeewan Ram Vishnoi, Taruna Yadav, Pawan Kumar Garg, Pushpinder Singh Khera, Sanjeev Misra

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2021

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Abstract

Objective

The purpose of the study was to investigate the incidence of pancreatic contour variations on multidetector CT (MDCT) for abdominal examinations.

Methods

A retrospective analysis of 700 MDCT scans was performed in patients who underwent triple phase CT abdomen between October 2018 and January 2021. After excluding 176 patients, finally total of 524 patients were included in the study. For simplification, we classified the pancreatic contour variations as classified by Ross et al. and Omeri et al. Pancreatic head–neck variations was classified into Type I-anterior, Type II-posterior and Type III-horizontal variety. Pancreatic body–tail variation was divided into Type Ia-anterior projection; Ib-posterior projection and Type IIa-globular, IIb-lobulated, IIc-tapered, and IId-bifid pancreatic tail.

Results

The most common type of variation in the head was Type II (n = 112, 21.3%) followed by Type III (n = 37, 7%) and Type I (n = 21, 4%). The most common type of variation in the body of pancreas was Type Ia (n = 33, 6.2%) followed by Type Ib (n = 13, 2.4%). In the tail region of pancreas, the most common variation was Type IIb (n = 21, 4%) followed by Type IIa (n = 19, 3.6%).

Conclusion

Pancreatic contour variations are not very uncommon in daily practice. Knowledge of these variations is important for surgeons, radiologists and avoids misjudgement of normal pancreatic tissue as tumor or lymph node especially on unenhanced or single phase MDCT.
Literatur
1.
Zurück zum Zitat Awais M, Rehman A, Baloch NU (2019) Gastric-type enteric duplication cyst in the tail of a bifid pancreas in association with complete intestinal malrotation. J Coll Physicians Surg Pak 29:489–490CrossRef Awais M, Rehman A, Baloch NU (2019) Gastric-type enteric duplication cyst in the tail of a bifid pancreas in association with complete intestinal malrotation. J Coll Physicians Surg Pak 29:489–490CrossRef
3.
Zurück zum Zitat Charnsangavej C (2000) Pathways of regional spread in pancreatic cancer. In: Meyers MA, editor. Dynamic radiology of the abdomen. Normal and pathologic anatomy 5th ed. New York, Springer-Verlag, pp 595–606 Charnsangavej C (2000) Pathways of regional spread in pancreatic cancer. In: Meyers MA, editor. Dynamic radiology of the abdomen. Normal and pathologic anatomy 5th ed. New York, Springer-Verlag, pp 595–606
5.
Zurück zum Zitat Dalla Pria HRF, Santiago RA, Velloni FG, D’ippolito G, (2018) Bifid pancreatic tail as cause of acute pancreatitis. Hepatobiliary Pancreat Dis Int 17:480–481CrossRef Dalla Pria HRF, Santiago RA, Velloni FG, D’ippolito G, (2018) Bifid pancreatic tail as cause of acute pancreatitis. Hepatobiliary Pancreat Dis Int 17:480–481CrossRef
6.
Zurück zum Zitat DeSouza SV, Singh RG, Yoon HD, Murphy R, Plank LD, Petrov MS (2018) Pancreas volume in health and disease: a systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol 12:757–766CrossRef DeSouza SV, Singh RG, Yoon HD, Murphy R, Plank LD, Petrov MS (2018) Pancreas volume in health and disease: a systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol 12:757–766CrossRef
8.
Zurück zum Zitat Lazzarin G, Romano L, Coletti G, Di Sibio A, Vicentini V, Fatayer MWA, Schietroma M, Pessia B, Leone M, Carlei F, Giuliani A (2020) Branch duct—IPMN and PanIN, in IgG4-autoimmune pancreatitis: a case report. Clin Case Rep 8:2111–2115CrossRef Lazzarin G, Romano L, Coletti G, Di Sibio A, Vicentini V, Fatayer MWA, Schietroma M, Pessia B, Leone M, Carlei F, Giuliani A (2020) Branch duct—IPMN and PanIN, in IgG4-autoimmune pancreatitis: a case report. Clin Case Rep 8:2111–2115CrossRef
9.
Zurück zum Zitat Maglione M, Ploeg RJ, Friend PJ (2013) Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation. Curr Opin Organ Transplant 18:83–88CrossRef Maglione M, Ploeg RJ, Friend PJ (2013) Donor risk factors, retrieval technique, preservation and ischemia/reperfusion injury in pancreas transplantation. Curr Opin Organ Transplant 18:83–88CrossRef
10.
Zurück zum Zitat Miyamoto R, Oshiro Y, Sano N, Inagawa S, Ohkohchi N (2019) Remnant pancreatic volume as an indicator of poor prognosis in pancreatic cancer patients after resection. Pancreatology 19:716–721CrossRef Miyamoto R, Oshiro Y, Sano N, Inagawa S, Ohkohchi N (2019) Remnant pancreatic volume as an indicator of poor prognosis in pancreatic cancer patients after resection. Pancreatology 19:716–721CrossRef
11.
Zurück zum Zitat Omeri AK, Matsumoto S, Kiyonaga M, Takaji R, Yamada Y, Kosen K, Mori H, Miyake H (2017) Contour variations of the body and tail of the pancreas: evaluation with MDCT. Jpn J Radiol 35:310–318CrossRef Omeri AK, Matsumoto S, Kiyonaga M, Takaji R, Yamada Y, Kosen K, Mori H, Miyake H (2017) Contour variations of the body and tail of the pancreas: evaluation with MDCT. Jpn J Radiol 35:310–318CrossRef
12.
Zurück zum Zitat Ross BA, Jeffrey RB Jr, Mindelzun RE (1996) Normal variations in the lateral contour of the head and neck of the pancreas mimicking neoplasm: evaluation with dual-phase helical CT. AJR Am J Roentgenol 166:799–801CrossRef Ross BA, Jeffrey RB Jr, Mindelzun RE (1996) Normal variations in the lateral contour of the head and neck of the pancreas mimicking neoplasm: evaluation with dual-phase helical CT. AJR Am J Roentgenol 166:799–801CrossRef
13.
Zurück zum Zitat Spaggiari M, Tzvetanov IG, Di Bella C, Oberholzer J (2018) Robotic pancreas transplantation. Gastroenterol Clin North Am 47:443–448CrossRef Spaggiari M, Tzvetanov IG, Di Bella C, Oberholzer J (2018) Robotic pancreas transplantation. Gastroenterol Clin North Am 47:443–448CrossRef
14.
Zurück zum Zitat Vullierme MP, Lagadec M (2016) Predisposing factors for pancreatic adenocarcinoma: what is the role of imaging? Diagn Interv Imaging 97:1233–1240CrossRef Vullierme MP, Lagadec M (2016) Predisposing factors for pancreatic adenocarcinoma: what is the role of imaging? Diagn Interv Imaging 97:1233–1240CrossRef
15.
Zurück zum Zitat Watson CJ, Harper SJ (2015) Anatomical variation and its management in transplantation. Am J Transplant 15:1459–1471CrossRef Watson CJ, Harper SJ (2015) Anatomical variation and its management in transplantation. Am J Transplant 15:1459–1471CrossRef
16.
Zurück zum Zitat Wiersema MJ, Hawes RH, Lehman GA, Kochman ML, Sherman S, Kopecky KK (1993) Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy 25:555–564CrossRef Wiersema MJ, Hawes RH, Lehman GA, Kochman ML, Sherman S, Kopecky KK (1993) Prospective evaluation of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with chronic abdominal pain of suspected pancreatic origin. Endoscopy 25:555–564CrossRef
Metadaten
Titel
MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance
verfasst von
Binit Sureka
Satya Jha
Arushi Yadav
Vaibhav Varshney
Subhash Soni
Jeewan Ram Vishnoi
Taruna Yadav
Pawan Kumar Garg
Pushpinder Singh Khera
Sanjeev Misra
Publikationsdatum
18.03.2021
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 9/2021
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-021-02735-4

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