Utility of Contrast-Enhanced Harmonic Endoscopic Ultrasonography to Diagnose Pancreaticobiliary Maljunction.

Contrast-enhanced harmonic endoscopic ultrasound Endoscopic ultrasonography Pancreaticobiliary Pancreaticobiliary maljunction Pancreatobiliary ducts

Journal

Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782

Informations de publication

Date de publication:
12 Jun 2024
Historique:
received: 08 03 2024
accepted: 20 05 2024
medline: 12 6 2024
pubmed: 12 6 2024
entrez: 12 6 2024
Statut: aheadofprint

Résumé

Detection of a common channel outside the duodenal wall is important in diagnosing pancreaticobiliary maljunction (PBM). The present study evaluated the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) in diagnosing PBM. This single-center retrospective study enrolled 45 patients who were diagnosed with PBM or high confluence of pancreatobiliary ducts (HCPBD) between January 2007 and December 2021. The diagnostic sensitivities of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI), and CH-EUS for diagnosing PBM were analyzed. Imaging findings were evaluated by two reviewers blinded to the clinicopathological results. Based on diagnostic criteria, 33 patients were diagnosed with PBM and 12 with HCPBD. Compared with the patients with HCPBD, those with PBM had significantly longer common channel (12.5 mm vs. 8.1 mm, P = 0.018) and common bile duct (13.0 mm vs. 8.6 mm, P = 0.049) lengths. The κ-coefficients for differentiating PBM and HCPBD were 0.871 between CE-CT and MRI, 0.330 between CE-CT and CH-EUS, and 0.611 between MRI and CH-EUS. The diagnostic sensitivity of CH-EUS (95.2%) was higher than that of CE-CT (83.3%) and MRI (82.8%), although the differences were not statistically significant. CH-EUS may be useful for the diagnosis of PBM.

Sections du résumé

BACKGROUND BACKGROUND
Detection of a common channel outside the duodenal wall is important in diagnosing pancreaticobiliary maljunction (PBM). The present study evaluated the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) in diagnosing PBM.
METHODS METHODS
This single-center retrospective study enrolled 45 patients who were diagnosed with PBM or high confluence of pancreatobiliary ducts (HCPBD) between January 2007 and December 2021. The diagnostic sensitivities of contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI), and CH-EUS for diagnosing PBM were analyzed. Imaging findings were evaluated by two reviewers blinded to the clinicopathological results.
RESULTS RESULTS
Based on diagnostic criteria, 33 patients were diagnosed with PBM and 12 with HCPBD. Compared with the patients with HCPBD, those with PBM had significantly longer common channel (12.5 mm vs. 8.1 mm, P = 0.018) and common bile duct (13.0 mm vs. 8.6 mm, P = 0.049) lengths. The κ-coefficients for differentiating PBM and HCPBD were 0.871 between CE-CT and MRI, 0.330 between CE-CT and CH-EUS, and 0.611 between MRI and CH-EUS. The diagnostic sensitivity of CH-EUS (95.2%) was higher than that of CE-CT (83.3%) and MRI (82.8%), although the differences were not statistically significant.
CONCLUSION CONCLUSIONS
CH-EUS may be useful for the diagnosis of PBM.

Identifiants

pubmed: 38864928
doi: 10.1007/s10620-024-08505-7
pii: 10.1007/s10620-024-08505-7
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Morine Y, Shimada M, Takamatsu H et al. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey. J Hepatobiliary Pancreat Sci 2013;20:472–480.
doi: 10.1007/s00534-013-0606-2 pubmed: 23579999
Kamisawa T, Ando H, Hamada Y et al. Japanese Study Group on Pancreaticobiliary Maljunction. Diagnostic criteria for pancreaticobiliary maljunction 2013. J Hepatobiliary Pancreat Sci 2014;21:159–161.
doi: 10.1002/jhbp.57 pubmed: 24307541
Kamisawa T, Takuma K, Itokawa F et al. Endoscopic diagnosis of pancreaticobiliary maljunction. World J Gastrointest Endosc 2011;3:1–5.
doi: 10.4253/wjge.v3.i1.1 pubmed: 21258599 pmcid: 3024475
Kitano M, Kudo M, Yamao K et al. Characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmonic endoscopic ultrasonography. Am J Gastroenterol 2012;107:303–310.
doi: 10.1038/ajg.2011.354 pubmed: 22008892
Kamata K, Takenaka M, Kitano M et al. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of localized gallbladder lesions. Dig Endosc 2018;30:98–106.
doi: 10.1111/den.12900 pubmed: 28632914
Kamata K, Kitano M, Omoto S et al. Contrast-enhanced harmonic endoscopic ultrasonography for differential diagnosis of pancreatic cysts. Endoscopy 2016;48:35–41.
pubmed: 26605974
Otsuka Y, Kamata K, Hyodo T et al. Utility of contrast-enhanced harmonic endoscopic ultrasonography for T-staging of patients with extrahepatic bile duct cancer. Surg Endosc 2022;36:3254–3260.
doi: 10.1007/s00464-021-08637-1 pubmed: 34462868
Kamata K, Kitano M, Kudo M et al. Value of EUS in early detection of pancreatic ductal adenocarcinomas in patients with intraductal papillary mucinous neoplasms. Endoscopy 2014;46:22–29.
pubmed: 24218310
Bhavsar MS, Vora HB, Giriyappa VH. Choledochal cysts: a review of literature. Saudi J Gastroenterol 2012;18:230–236.
doi: 10.4103/1319-3767.98425 pubmed: 22824764 pmcid: 3409882
Kamisawa T, Amemiya K, Tu Y et al. Clinical significance of a long common channel. Pancreatology 2002;2:122–128.
doi: 10.1159/000055902 pubmed: 12123092
Kimura K, Ohto M, Saisho H et al. Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterology 1985;89:1258–1265.
doi: 10.1016/0016-5085(85)90641-9 pubmed: 4054518
Misra SP, Dwivedi M. Pancreaticobiliary ductal union. Gut 1990;31:1144–1149.
doi: 10.1136/gut.31.10.1144 pubmed: 2083859 pmcid: 1378740
Dowdy GS Jr, Waldron GW, Brown WG. Surgical anatomy of the pancreatobiliary ductal system. Observations. Arch Surg 1962;84:229–246.
doi: 10.1001/archsurg.1962.01300200077006 pubmed: 13887616
Hyodo T, Kumano S, Kushihata F et al. CT and MR cholangiography: advantages and pitfalls in perioperative evaluation of biliary tree. Br J Radiol 2012;85:887–896.
doi: 10.1259/bjr/21209407 pubmed: 22422383 pmcid: 3474084
Tokumaru K, Ido K, Ueno N et al. A case of anomalous arrangement of the pancreaticobiliary ductal system demonstrated by intraductal ultrasonography. Am J Gastroenterol 1994;89:1893–1895.
pubmed: 7942691
Kamisawa T, Kuruma S, Tabata T et al. Pancreaticobiliary maljunction and biliary cancer. J Gastroenterol 2015;50:273–279.
doi: 10.1007/s00535-014-1015-2 pubmed: 25404143
Ono A, Arizono S, Isoda H et al. Imaging of pancreaticobiliary maljunction. Radiographics 2020;40:378–392.
doi: 10.1148/rg.2020190108 pubmed: 31951513
Jayaraman MV, Mayo-Smith WW, Movson JS et al. CT of the duodenum: an overlooked segment gets its due. Radiographics 2001;12 Spec No:S147–S160.
doi: 10.1148/radiographics.21.suppl_1.g01oc01s147
Kamisawa T, Tu Y, Egawa N et al. MRCP of congenital pancreaticobiliary malformation. Abdom Imaging 2007;32:129–133.
doi: 10.1007/s00261-006-9005-3 pubmed: 16680507
Kim MJ, Han SJ, Yoon CS et al. Using MR cholangiopancreatography to reveal anomalous pancreaticobiliary ductal union in infants and children with choledochal cysts. AJR Am J Roentgenol 2002;179:209–214.
doi: 10.2214/ajr.179.1.1790209 pubmed: 12076938
Sugiyama M, Atomi Y. Endoscopic ultrasonography for diagnosing anomalous pancreaticobiliary junction. Gastrointest Endosc 1997;45:261–267.
doi: 10.1016/S0016-5107(97)70268-2 pubmed: 9087832
Mitake M, Nakazawa S, Naitoh Y et al. Value of endoscopic ultrasonography in the detection of anomalous connections of the pancreatobiliary duct. Endoscopy 1991;23:117–120.
doi: 10.1055/s-2007-1010635 pubmed: 1860437
Yusuf TE, Bhutani MS. Role of endoscopic ultrasonography in diseases of the extrahepatic biliary system. J Gastroenterol Hepatol 2004;19:243–250.
doi: 10.1111/j.1440-1746.2003.03142.x pubmed: 14748869
Kitano M, Yamashita Y, Kamata K et al. Working group for the International Consensus Guidelines for Contrast-Enhanced Harmonic Endoscopic Ultrasound. The Asian Federation of Societies for Ultrasound in Medicine and Biology (AFSUMB) guidelines for contrast-enhanced endoscopic ultrasound. Ultrasound Med Biol 2021;47:1433–1447.
doi: 10.1016/j.ultrasmedbio.2021.01.030 pubmed: 33653627

Auteurs

Tomohiro Yamazaki (T)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Ken Kamata (K)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan. ky11@leto.eonet.ne.jp.

Tomoko Hyodo (T)

Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan.

Sung-Woon Im (SW)

Department of Radiology, Kindai University Faculty of Medicine, Osaka, Japan.

Hidekazu Tanaka (H)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Akihiro Yoshida (A)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Tomohiro Fukunaga (T)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Shunsuke Omoto (S)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Kosuke Minaga (K)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Mamoru Takenaka (M)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Masatoshi Kudo (M)

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Classifications MeSH