Abstract
Objective
To determine the ability of multidetector computed tomography (MPR-MDCT) to identify and classify the juxtapapillary duodenal diverticulum (JPDD), with ERCP findings as the gold standard.
Methods
We retrospectively reviewed all ERCP examinations (n: 455) performed between January 2010 to December 2018 and selected 105 patients with JPDD as the inclusion criteria. Of those, 28 patients were excluded because of advanced pancreatic carcinoma, incomplete MDCT examinations and biliary catheter insertion. Finally, MDCT examinations of 77 patients with JPDD were assessed for the presence and type of JPDD.
Results
MPR-MDCT was able to identify 71 (92.2%) JPDD in 77 cases with 88.9% accuracy, 83.3% sensitivity, and 91.6% specificity in classifying the type of JPDD. MPR-MDCT performed best in determining type 1 JPDD, with accuracy of 95.4% compared with type 2 (83.3%) and type 3 (87.8%). There was no significant difference between age, gender, incidence of biliary stones and pancreatitis between each type of JPDD. No correlation of sizes with types of JPDD was found.
Conclusions
MPR-MDCT can accurately identify and classify JPDD. This information will be useful in determining the difficulty of ERCP.
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Acknowledgements
The authors would like to express special thanks to Mr. Takashi Takiguchi, a medical student in our university, and Cathel Kerr BSc, Ph.D. from Edanz Group (www.edanzediting.com/ac), for editing a draft of the manuscript.
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The authors of this manuscript have no conflicts of interest and declare no relationship with any companies, whose products or services may be or will be related to the subject matter of the article.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975 (revised in 2008). This retrospective study was approved by our institutional review boards.
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Silman, C., Matsumoto, S., Yamada, Y. et al. Evaluation of juxtapapillary duodenal diverticula using multiplanar reformation in MDCT: correlation with ERCP findings. Jpn J Radiol 38, 968–972 (2020). https://doi.org/10.1007/s11604-020-00995-5
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DOI: https://doi.org/10.1007/s11604-020-00995-5