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KMID : 1038120230560040510
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Clinical Endoscopy
2023 Volume.56 No. 4 p.510 ~ p.520
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Diagnostic value of homogenous delayed enhancement in contrast-enhanced computed tomography images and endoscopic ultrasound-guided tissue acquisition for patients with focal autoimmune pancreatitis
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Keisuke Yonamine
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
Kais Rtibi
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Abstract
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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.
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KEYWORD
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Autoimmune pancreatitis, Computed tomography, Endosonography, Fine-needle aspiration, Pancreatic neoplasms
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