Aims and objectives
Pancreas divisum (PD) is the most common congenital anomaly of the pancreatic ductal system (1).
It results from a failure of the two pancreatic buds,
the ventral and the dorsal buds,
to fuse during the seventh week of gestation (2).
The clinical significance of pancreas divisum is still controversial.
It occurs in 4-10% of the general population.
Most people with pancreas divisum are asymptomatic (3) and PD is detected incidentally on imaging.
Several studies,
however,
have shown a higher frequency of chronic abdominal pain,
recurrent...
Methods and materials
This is an IRB-approved retrospective study.
We reviewed 86 patients (41 male and 45 female,
aged 16-85 years; mean age 53 years) with PD and symptomatic chronic pancreatitis who underwent MRI and MRCP at our institution between January 2013 and December 2016.
Patients were stratified by age in three groups: <40 years (26 patients; M:16,
F:10),
41-60 years (27 patients; M:11,
F:16 ),
>60 years (33 patients; M:14,
F:19).
Two readers in consensus evaluated the following parenchymal features: thickness of the organ,
regularity of the...
Results
74 patients were affected by complete PD and 12 by incomplete PD.
Hypointensity in T1 sequences and irregularity of the main pancreatic duct were significantly more often limited to dorsal pancreas in patients aged <40 (p=0.03; p=0.02) while the entire pancreas was significantly involved in patients aged >60 (Fig.1;Fig.2).
Isolated dorsal T1-hypointensity was observed in 86% of the patients aged <40 while involvement of the entire pancreas was observed in 50% of the patients aged >60 (Tab.1).
Increasing age was significantly associated with reduction in...
Conclusion
Patients with PD develop chronic pancreatitis in the dorsal pancreas earlier than in the ventral pancreas,
and morphological alterations are significantly associated with increasing patient age.
Personal information
All Authors:
Istituto di Radiologia
Università di Verona
Policlinico GB Rossi
P.le L.A.
Scuro 10
37134 Verona
Italy
Corresponding author:
Maria Laura Monti
[email protected]
References
1) Sadler,
T.
W.
(Thomas W.
& Langman,
J.
M.
embryology.
Langman’s medical embryology.
Journal of Chemical Information and Modeling 53,
(2013).
2) Tadokoro,
H.,
Takase,
M.
& Nobukawa,
B.
Development and congenital anomalies of the pancreas.
Anat.
Res.
Int.
2011,
351217 (2011).
3) Bülow,
R.
et al.
Anatomic variants of the pancreatic duct and their clinical relevance: an MR-guided study in the general population.
Eur.
Radiol.
24,
3142–3149 (2014).
4) Cotton,
P.
B.
Congenital anomaly of pancreas divisum as cause of obstructive pain and...