Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis
- Author:
Keisuke YONAMINE
1
;
Shinsuke KOSHITA
;
Yoshihide KANNO
;
Takahisa OGAWA
;
Hiroaki KUSUNOSE
;
Toshitaka SAKAI
;
Kazuaki MIYAMOTO
;
Fumisato KOZAKAI
;
Hideyuki ANAN
;
Haruka OKANO
;
Masaya OIKAWA
;
Takashi TSUCHIYA
;
Takashi SAWAI
;
Yutaka NODA
;
Kei ITO
Author Information
- Publication Type:Original Article
- From:Clinical Endoscopy 2023;56(4):510-520
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background/Aims:We aimed to investigate (1) promising clinical findings for the recognition of focal type autoimmune pancreatitis (FAIP) and (2) the impact of endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) on the diagnosis of FAIP.
Methods:Twenty-three patients with FAIP were involved in this study, and 44 patients with resected pancreatic ductal adenocarcinoma (PDAC) were included in the control group.
Results:(1) Multivariate analysis revealed that homogeneous delayed enhancement on contrast-enhanced computed tomography was a significant factor indicative of FAIP compared to PDAC (90% vs. 7%, p=0.015). (2) For 13 of 17 FAIP patients (76.5%) who underwent EUS-TA, EUS-TA aided the diagnostic confirmation of AIPs, and only one patient (5.9%) was found to have AIP after surgery. On the other hand, of the six patients who did not undergo EUS-TA, three (50.0%) underwent surgery for pancreatic lesions.
Conclusions:Homogeneous delayed enhancement on contrast-enhanced computed tomography was the most useful clinical factor for discriminating FAIPs from PDACs. EUS-TA is mandatory for diagnostic confirmation of FAIP lesions and can contribute to a reduction in the rate of unnecessary surgery for patients with FAIP.
