Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study
Abstract Background No previous studies have examined the possible relationship between intraductal papillary mucinous neoplasm (IPMN) and the developmental ductal variations of the pancreas, such as an ansa pancreatica and a meandering main pancreatic duct (MMPD). Methods This retrospective cross-s...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-08-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-022-02465-w |
| _version_ | 1818082457827672064 |
|---|---|
| author | Katarina Johansson Harri Mustonen Hanna Seppänen Tiina E. Lehtimäki |
| author_facet | Katarina Johansson Harri Mustonen Hanna Seppänen Tiina E. Lehtimäki |
| author_sort | Katarina Johansson |
| collection | DOAJ |
| description | Abstract Background No previous studies have examined the possible relationship between intraductal papillary mucinous neoplasm (IPMN) and the developmental ductal variations of the pancreas, such as an ansa pancreatica and a meandering main pancreatic duct (MMPD). Methods This retrospective cross-sectional study enrolled 214 patients, 108 with IPMN disease and 106 subjects from a community at the tertiary care unit. The main pancreatic duct (MPD) was evaluated in the head of the pancreas by its course, which were non-MMPD: descending, vertical, and sigmoid, or MMPD including loop types, reverse-Z subtypes, and an N-shape, which was identified for the first time in this study. IPMN patients were also evaluated for worrisome features (WF) or high-risk stigmata (HRS), and the extent of IPMN cysts. Results Among IPMN patients, 18.4% had MMPD, which we observed in only 3.0% of the control group (P < 0.001). Patients with MMPD were more likely to belong to the IPMN group compared with non-MMPD patients [odds ratio (OR) 6.4, 95% confidence interval (CI) 2.2–24.9]. Compared with a descending shape MPD, IPMN patients with an N-shaped MPD were more likely to have a cystic mural nodule (OR 5.9, 95% CI 1.02–36.0). The presence of ansa pancreatica associated with more extent IPMN disease (OR 12.8, 95% CI 2.6–127.7). Conclusions IPMN patients exhibited an MMPD more often than control patients. Ansa pancreatica associated with multiple cysts. Furthermore, an N-shape in IPMN patients associated with cystic mural nodules, suggesting that this shape serves as a risk factor for more severe IPMN. |
| first_indexed | 2024-12-10T19:22:25Z |
| format | Article |
| id | doaj.art-8750560a0fea49bf9dee48c019236726 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-10T19:22:25Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-8750560a0fea49bf9dee48c0192367262022-12-22T01:36:28ZengBMCBMC Gastroenterology1471-230X2022-08-012211910.1186/s12876-022-02465-wAnatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional studyKatarina Johansson0Harri Mustonen1Hanna Seppänen2Tiina E. Lehtimäki3Department of Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University HospitalDepartment of Surgery, University of Helsinki and Helsinki University HospitalDepartment of Surgery, University of Helsinki and Helsinki University HospitalDepartment of Radiology, HUS Diagnostic Center, University of Helsinki and Helsinki University HospitalAbstract Background No previous studies have examined the possible relationship between intraductal papillary mucinous neoplasm (IPMN) and the developmental ductal variations of the pancreas, such as an ansa pancreatica and a meandering main pancreatic duct (MMPD). Methods This retrospective cross-sectional study enrolled 214 patients, 108 with IPMN disease and 106 subjects from a community at the tertiary care unit. The main pancreatic duct (MPD) was evaluated in the head of the pancreas by its course, which were non-MMPD: descending, vertical, and sigmoid, or MMPD including loop types, reverse-Z subtypes, and an N-shape, which was identified for the first time in this study. IPMN patients were also evaluated for worrisome features (WF) or high-risk stigmata (HRS), and the extent of IPMN cysts. Results Among IPMN patients, 18.4% had MMPD, which we observed in only 3.0% of the control group (P < 0.001). Patients with MMPD were more likely to belong to the IPMN group compared with non-MMPD patients [odds ratio (OR) 6.4, 95% confidence interval (CI) 2.2–24.9]. Compared with a descending shape MPD, IPMN patients with an N-shaped MPD were more likely to have a cystic mural nodule (OR 5.9, 95% CI 1.02–36.0). The presence of ansa pancreatica associated with more extent IPMN disease (OR 12.8, 95% CI 2.6–127.7). Conclusions IPMN patients exhibited an MMPD more often than control patients. Ansa pancreatica associated with multiple cysts. Furthermore, an N-shape in IPMN patients associated with cystic mural nodules, suggesting that this shape serves as a risk factor for more severe IPMN.https://doi.org/10.1186/s12876-022-02465-wIntraductal papillary mucinous neoplasm (IPMN)Meandering main pancreatic duct (MMPD)Ansa pancreaticaWorrisome featuresMRI |
| spellingShingle | Katarina Johansson Harri Mustonen Hanna Seppänen Tiina E. Lehtimäki Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study BMC Gastroenterology Intraductal papillary mucinous neoplasm (IPMN) Meandering main pancreatic duct (MMPD) Ansa pancreatica Worrisome features MRI |
| title | Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study |
| title_full | Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study |
| title_fullStr | Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study |
| title_full_unstemmed | Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study |
| title_short | Anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients: a cross-sectional study |
| title_sort | anatomical pancreatic variants in intraductal papillary mucinous neoplasm patients a cross sectional study |
| topic | Intraductal papillary mucinous neoplasm (IPMN) Meandering main pancreatic duct (MMPD) Ansa pancreatica Worrisome features MRI |
| url | https://doi.org/10.1186/s12876-022-02465-w |
| work_keys_str_mv | AT katarinajohansson anatomicalpancreaticvariantsinintraductalpapillarymucinousneoplasmpatientsacrosssectionalstudy AT harrimustonen anatomicalpancreaticvariantsinintraductalpapillarymucinousneoplasmpatientsacrosssectionalstudy AT hannaseppanen anatomicalpancreaticvariantsinintraductalpapillarymucinousneoplasmpatientsacrosssectionalstudy AT tiinaelehtimaki anatomicalpancreaticvariantsinintraductalpapillarymucinousneoplasmpatientsacrosssectionalstudy |