Mella Jose Manuel, Gómez Estanislao Jesús, Omodeo Mariana, Manzotti Matias, Roel Mariela, Pereyra Lisandro, Fischer Carolina, Panigadi Nicolás, González Raquel, Luna Pablo, Pedreira Silvia Cecilia, Cimmino Daniel Gustavo, Boerr Luis Alberto
Av. Pueyrredón 1640, Hospital Alemán, Zip Code 1118, CABA, Buenos Aires, Argentina.
Av. Pueyrredón 1640, Hospital Alemán, Zip Code 1118, CABA, Buenos Aires, Argentina.
Gastroenterol Hepatol. 2018 May;41(5):293-301. doi: 10.1016/j.gastrohep.2017.12.005. Epub 2018 Feb 9.
Most pancreatic cysts (PCs) found incidentally by CT and MRI scans might not be clinically important according to the Fukuoka guidelines, the American Gastroenterological Association (AGA) guidelines and European guidelines.
To determine and compare the prevalence of incidental clinically important PCs (CIPCs).
Abdominal contrast-enhanced CT or MRI scans performed during a one-year period were retrospectively reviewed to identify incidental PCs. CIPCs were defined as those cysts that would be capable of triggering further evaluation with endoscopic ultrasound, immediate surveillance (within 3-6 months) and/or surgery. Prevalence was calculated as the number of patients with CIPCs per 100 subjects imaged (%).
Sixty patients (mean age 70±14 years) out of 565 were found to have incidental PCs, representing a prevalence of 8.7% (95% CI 6.3-11.5) in CT scans and 27.5% (95% CI 16-41) in MRI scans. Seven patients (11.6%, 95% CI 5-22) had CIPCs based on size ≥ 30mm (n=5), size ≥ 30mm and pancreatic duct (PD) dilation (n=1) and PD dilation and presence of solid component (n=1). Based on the Fukuoka guidelines, the prevalence of CIPCs was 1.2% (95% CI 0.4-2.5) in CT scans (6/507) and 1.7% (95% CI 0.1-9) in MRI scans (1/58). Based on the AGA and European guidelines, the prevalence of CIPCs was 0.2% (95% CI 0.1-1) in CT scans (1/507) and 1.7% (95% CI 0.1-9) in MRI scans (1/58). Patients with PCs initially classified as "AGA- or European-positive" had a higher surgical probability and this decision was taken earlier in the follow-up.
In our cohort, the prevalence of important incidental pancreatic cysts was not negligible at around 1% according to current guidelines.
根据福冈指南、美国胃肠病学会（AGA）指南和欧洲指南，大多数通过CT和MRI扫描偶然发现的胰腺囊肿（PCs）可能在临床上并不重要。
确定并比较偶然发现的具有临床重要性的PCs（CIPCs）的患病率。
回顾性分析在一年期间进行的腹部增强CT或MRI扫描，以识别偶然发现的PCs。CIPCs定义为那些能够引发内镜超声进一步评估、立即监测（3 - 6个月内）和/或手术的囊肿。患病率计算为每100例接受成像检查的患者中CIPCs患者的数量（%）。
565例患者中有60例（平均年龄70±14岁）发现有偶然的PCs，CT扫描中的患病率为8.7%（95%可信区间6.3 - 11.5），MRI扫描中的患病率为27.5%（95%可信区间16 - 41）。7例患者（11.6%，95%可信区间5 - 22）基于囊肿大小≥30mm（n = 5）、大小≥30mm且胰管（PD）扩张（n = 1）以及PD扩张且存在实性成分（n = 1）而患有CIPCs。根据福冈指南，CT扫描中CIPCs的患病率为1.2%（95%可信区间0.4 - 2.5）（6/507），MRI扫描中为1.7%（95%可信区间0.1 - 9）（1/58）。根据AGA和欧洲指南，CT扫描中CIPCs的患病率为0.2%（95%可信区间(0.1 - 1)）（1/507），MRI扫描中为1.7%（95%可信区间0.1 - 9）（(1/{\rm 58})）。最初被归类为“AGA或欧洲阳性”的PCs患者手术概率更高，且这一决定在随访中更早做出。
在我们的队列中，根据当前指南，重要的偶然胰腺囊肿患病率约为1%，不可忽视。
