Diagnostische Strategie und differenzialtherapeutisches Vorgehen bei zystischen Läsionen des Pankreas = Diagnostic strategy and differential therapeutic approach for cystic lesions of the pancreas

Clinical/methodical issueCystic pancreatic lesions (CPL) are diagnosed with increasing frequency. Because up to 60 % of CPL are classified as malignant or premalignant, every CPL should be fully investigated and clarified. Serous CPL with low risk of malignancy must be differentiated from mucinous C...

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Hauptverfasser: Mayer, Philipp (VerfasserIn) , Tjaden, Christin (VerfasserIn) , Klauß, Miriam (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Deutsch
Englisch
Veröffentlicht: 29. März 2016
In: Der Radiologe
Year: 2016, Jahrgang: 56, Heft: 4, Pages: 338-347
ISSN:1432-2102
DOI:10.1007/s00117-016-0091-0
Online-Zugang:Verlag, Volltext: https://doi.org/10.1007/s00117-016-0091-0
Verlag, Volltext: https://link.springer.com/article/10.1007%2Fs00117-016-0091-0
Volltext
Verfasserangaben:P. Mayer, C. Tjaden, M. Klauß

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520 |a Clinical/methodical issueCystic pancreatic lesions (CPL) are diagnosed with increasing frequency. Because up to 60 % of CPL are classified as malignant or premalignant, every CPL should be fully investigated and clarified. Serous CPL with low risk of malignancy must be differentiated from mucinous CPL with relevant potential malignancy (intraductal papillary mucinous neoplasm IPMN) and mucinous cystic neoplasm (MCN) as well as from harmless pseudocysts.Standard radiological methodsCross-sectional imaging with computed tomography (CT) and magnetic resonance imaging (MRI) plays a crucial role in the diagnostics of CPL.Methodical innovationsAn algorithm for the differential diagnostic classification of CPL is presented.PerformanceThe connection to the pancreatic duct is the key diagnostic criterion to differentiate IPMN from all other CPL. An exception to this rule is that pseudocysts can also show a connection to the pancreatic duct. A further classification of CPL with no connection to the pancreatic duct can be made by morphological criteria and correlation of the radiological findings with patient age, sex, history and symptoms.Practical recommendationsDepending on the diagnosis and hence the malignant potential the indications for surgery or watch and wait have to be discussed in an interdisciplinary cooperation. Due to its higher soft tissue contrast MRI is often superior to CT for depiction of CPL morphology. 
650 4 |a Differential diagnostic classification 
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650 4 |a Duct connection 
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650 4 |a Mucinous cystic neoplasms 
650 4 |a Muzinös zystische Neoplasie 
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