1675. Incidentally Detected Pancreatic Duct Dilatation on Ultrasound: Yield of Subsequent MRI and Findings Correlated with Causative Pathology
Authors* Denotes Presenting Author
Abraham Bezuidenhout *;
Beth Israel Deaconess Medical Center
The clinical significance and current management of patients with an incidentally found dilated pancreatic duct on abdominal ultrasound with no visualized underlying cause are not clear. The purpose of this study included assessing the diagnostic yield of subsequent MRCP in the evaluation of these patients and to identify other variables that would predict underlying pancreatic pathology.
Materials and Methods:
We included all patients in which MRCP was recommended for evaluation of a dilated pancreatic duct incidentally found on abdominal ultrasound without an identified underlying etiology from 2011 - 2017. Patient clinical and laboratory data were retrieved from medical records. All patients with pre-existing pancreatic pathology, invasive imaging or intervention were excluded. Histology or clinical follow-up was used as reference standard.
A total of 189 patients were identified: 58/189 (31%) patients underwent MRCP as per recommendation of which 36/58 (62%) had pancreatic duct dilation on MRCP, the others did not. In 17/36 (47%) patients, a specific pancreatic cause for pancreatic duct dilation was identified, including 7 (19%) malignant and 10 (28%) benign causes. In 19/36 (53%) patients, a cause for dilation was not identified. The presence as well as the degree of associated common bile duct dilation were predictors of underlying pancreaticobiliary malignancy.
An incidentally found dilated pancreatic duct on abdominal ultrasound with no visualized underlying cause is not a finding that should be ignored. MRCP appears to be a good non-invasive method for identifying the underlying cause in these patients and in detecting pancreaticicobiliary malignancy.