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Characterization of Pancreatic Serous Cystadenoma on Dual-Phase Multidetector Computed Tomography

Chu, Linda C. MD; Singhi, Aatur D. MD, PhD; Hruban, Ralph H. MD; Fishman, Elliot K. MD

Journal of Computer Assisted Tomography: March/April 2014 - Volume 38 - Issue 2 - p 258–263
doi: 10.1097/RCT.10.1097/RCT.0b013e3182ab1556
Abdominal Imaging

Objective The objective of the study was to characterize pancreatic serous cystadenomas on dual-phase multidetector computed tomography in a surgical series.

Materials and Methods This is a retrospective review of preoperative dual-phase multidetector computed tomographic scans from 68 patients with surgically resected and pathologically confirmed pancreatic serous cystadenomas.

Results Pancreatic serous cystadenomas were most commonly found in the tail (39%). The mean (SD) axial dimension was 4.5 (2.7) cm. A total of 36% contained internal calcifications. Dilatation of the main pancreatic duct (14%) and pancreatic parenchymal atrophy (11%) were uncommon. The mean (SD) attenuation of components with the highest attenuation was 49.1 (35.0) Hounsfield units on the arterial phase and 48.5 (33.4) Hounsfield units on the portal venous phase. Only 20% of neoplasms demonstrated “classic” morphology, as defined by multiple thin nonenhancing septations, calcifications, as well as the absence of main pancreatic duct dilatation and vascular involvement.

Conclusions Only 20% of surgically resected serous cystadenomas fulfilled classic morphology. Attenuation was helpful in differentiating serous cystadenomas from insulinomas and other cystic pancreatic masses, but it was not helpful in differentiation from pancreatic adenocarcinomas. Morphologic features were more helpful in differentiating serous cystadenomas from malignant masses.

From the *The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD; †Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA; and ‡Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Hospital, Baltimore, MD.

Received for publication July 28, 2013; accepted October 9, 2013.

Reprints: Linda C. Chu, MD, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, 601 N Caroline St, Baltimore, MD 21287 (e-mail: lindachu@jhmi.edu).

The authors declare no conflict of interest.

Received Certificate of Merit at the 2012 Annual Meeting of the American Roentgen Ray Society Meeting.

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