TY - JOUR
T1 - Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum
T2 - A tertiary center experience
AU - Kushnir, Vladimir M.
AU - Wani, Sachin B.
AU - Fowler, Kathryn
AU - Menias, Christine
AU - Varma, Rakesh
AU - Narra, Vamsi
AU - Hovis, Christine
AU - Murad, Faris M.
AU - Mullady, Daniel K.
AU - Jonnalagadda, Sreenivasa S.
AU - Early, Dayna S.
AU - Edmundowicz, Steven A.
AU - Azar, Riad R.
PY - 2013/4
Y1 - 2013/4
N2 - OBJECTIVES: There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS: For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. RESULTS: The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P < 0.001 for each). On review by expert radiologists, the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (κ = 0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (κ = 0.43). CONCLUSIONS: Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.
AB - OBJECTIVES: There are limited data comparing imaging modalities in the diagnosis of pancreas divisum. We aimed to: (1) evaluate the sensitivity of endoscopic ultrasound (EUS), magnetic resonance cholangiopancreatography (MRCP), and multidetector computed tomography (MDCT) for pancreas divisum; and (2) assess interobserver agreement (IOA) among expert radiologists for detecting pancreas divisum on MDCT and MRCP. METHODS: For this retrospective cohort study, we identified 45 consecutive patients with pancreaticobiliary symptoms and pancreas divisum established by endoscopic retrograde pancreatography who underwent EUS and cross-sectional imaging. The control group was composed of patients without pancreas divisum who underwent endoscopic retrograde pancreatography and cross-sectional imaging. RESULTS: The sensitivity of EUS for pancreas divisum was 86.7%, significantly higher than the sensitivity reported in the medical records for MDCT (15.5%) or MRCP (60%) (P < 0.001 for each). On review by expert radiologists, the sensitivity of MDCT increased to 83.3% in cases where the pancreatic duct was visualized, with fair IOA (κ = 0.34). Expert review of MRCPs did not identify any additional cases of pancreas divisum; IOA was moderate (κ = 0.43). CONCLUSIONS: Endoscopic ultrasound is a sensitive test for diagnosing pancreas divisum and is superior to MDCT and MRCP. Review of MDCT studies by expert radiologists substantially raises its sensitivity for pancreas divisum.
KW - Computed tomography
KW - Endoscopic retrograde cholangiopancreatography
KW - Endoscopic ultrasound
KW - Magnetic resonance cholangiopancreatography
KW - Pancreas divisum
KW - Pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=84884213082&partnerID=8YFLogxK
U2 - 10.1097/MPA.0b013e31826c711a
DO - 10.1097/MPA.0b013e31826c711a
M3 - Article
C2 - 23211370
AN - SCOPUS:84884213082
SN - 0885-3177
VL - 42
SP - 436
EP - 441
JO - Pancreas
JF - Pancreas
IS - 3
ER -