From the Department of Internal Medicine II.
Institute of Diagnostic and Interventional Radiology, Technical University of Munich, School of Medicine and Health, Department Clinical Medicine, University Hospital rechts der Isar.
Pancreas. 2023 Jul 1;52(6):e315-e320. doi: 10.1097/MPA.0000000000002264. Epub 2023 Nov 1.
Because IPMNs are potentially malignant, surveillance of IPMN is recommended by magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS). The aim of the study was the evaluation of the concordance between EUS and MRI regarding cyst size.
Retrospective data analysis was done for patients with IPMN in whom EUS and MRI were performed simultaneously (≤60 days). The measured cyst size of both procedures was compared by Bland-Altman plots. Agreement of cyst localization and dilation of main pancreatic duct was assessed using kappa statistics.
Fifty-nine cases were evaluated (median age, 71 years; 65% female; median time interval between both investigations, 17 days). The mean difference of IPMN maximal diameter between EUS and MRI was 0.55 mm with a prediction interval of -9.20 to +10.29 mm for 95% of the expected differences. There was strong interobserver agreement regarding cyst localization ( κ = 0.669, P = 1.06e -13 ) and the width of main pancreatic duct (<5, 5-9, and ≥10 mm; κ = 0.676 caput, κ = 0.823 corpus).
We found a clinically relevant difference in cyst size comparing EUS and MRI. Therefore, alternating EUS and MRI for follow-up of the "worrisome feature" size growth is not reasonable.
由于 IPMN 具有潜在恶性，因此推荐使用磁共振成像（MRI）和内镜超声（EUS）进行 IPMN 的监测。本研究旨在评估 EUS 和 MRI 在囊腔大小方面的一致性。
对同时进行 EUS 和 MRI 检查（≤60 天）的 IPMN 患者进行回顾性数据分析。通过 Bland-Altman 图比较两种方法测量的囊腔大小。使用 κ 统计评估囊腔定位和主胰管扩张的一致性。
共评估了 59 例患者（中位年龄 71 岁，女性占 65%；两次检查的中位时间间隔为 17 天）。EUS 和 MRI 测量的 IPMN 最大直径的平均差异为 0.55mm，95%的预期差异的预测区间为-9.20 至+10.29mm。囊腔定位的观察者间一致性很强（κ=0.669，P=1.06e-13），主胰管的宽度（<5mm、5-9mm 和≥10mm；κ=0.676 头、κ=0.823 体）也具有高度一致性。
EUS 和 MRI 比较时，囊腔大小存在临床相关差异。因此，交替使用 EUS 和 MRI 来监测“有问题的特征”的大小增长是不合理的。
