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Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients

Zehra Hilal Adibelli

Zehra Hilal Adibelli

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Adibelli, Zehra Hilal
, 
Mustafa Adatepe

Mustafa Adatepe

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Adatepe, Mustafa
, 
Cetin Imamoglu

Cetin Imamoglu

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Imamoglu, Cetin
, 
Ozgur Sipahi Esen

Ozgur Sipahi Esen

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Esen, Ozgur Sipahi
, 
Nazif Erkan

Nazif Erkan

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Erkan, Nazif
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Mehmet Yildirim

Mehmet Yildirim

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Yildirim, Mehmet
  
08 sept 2016
Anatomic variations of the pancreatic duct and their relevance with the Cambridge classification system: MRCP findings of 1158 consecutive patients's Cover Image
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Categoría del artículo: Research Article
Publicado en línea: 08 sept 2016
Páginas: 370 - 377
Recibido: 09 may 2016
Aceptado: 06 jun 2016
DOI: https://doi.org/10.1515/raon-2016-0041
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© 2016 Radiol Oncol
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Descending course of pancreatic duct in 60 year of woman who had cholecystectomy. There is a Type 3b variation (the right posterior duct drained into the main hepatic duct) at the level of bifurcation of the biliary ducts and mild forms of renal pelvis dilatation.
Descending course of pancreatic duct in 60 year of woman who had cholecystectomy. There is a Type 3b variation (the right posterior duct drained into the main hepatic duct) at the level of bifurcation of the biliary ducts and mild forms of renal pelvis dilatation.
Sigmoid course of pancreatic duct in 49 year-old woman with and trifurcation at the level of bifurcation of the biliary ducts (*): Sigmoid course of the pancreatic duct, (**): choledocholithiasis.
Sigmoid course of pancreatic duct in 49 year-old woman with and trifurcation at the level of bifurcation of the biliary ducts (*): Sigmoid course of the pancreatic duct, (**): choledocholithiasis.
Vertical course (*) of pancreatic duct in 55 year-old woman who had cholecystectomy.
Vertical course (*) of pancreatic duct in 55 year-old woman who had cholecystectomy.
Loop course (*) of pancreatic duct in in 38 year-old woman with choledocholithiasis (**).
Loop course (*) of pancreatic duct in in 38 year-old woman with choledocholithiasis (**).
Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.
Variations in the configuration of the pancreas duct. Type 1: Bifid configuration with dominant duct of Wirsung, Type 2: Bifid configuration with dominant duct of Santorini without divisum, Type 3: Rudimentary non-draining duct of Santorini, Type 4: Pancreas divisum, Type 5: Ansa pancreatica.

The distribution of pancreas divisum subtypes_

Pancreas divisum subtypesNumber of variationsMale, n (%)Female, n (%)
P. divisum subtype 124 (44.4)8 (40)16 (47)
P. divisum subtype 220 (37)7 (35)13 (38.2)
P. divisum subtype 310 (18.6)5 (25)5 (14.8)
Total542034

The distribution of ductal configuration types of main pancreatic duct

Variation in configurationNumber of Variations, n (%)Male, n (%)Female, n (%)
Type 1521 (45)233 (47.5)288 (43.1)
Type 242 (3.6)11 (2.3)31 (4.6)
Type 3528 (45.6)220 (44.9)308 (46.1)
Type 454 (4.6)19 (3.9)35 (5.3)
Type 513 (1.2)7 (1.4)6 (0.9)
Total1158490668

THE distribution of the course types of main pancreatic duct

Number of variations n (%)Male n (%)Female n (%)
Descending type724 (62.5)321 (65.5)403 (60)
Sigmoid type343 (30)134 (27.5)199 (30)
Vertical type68 (5.5)17 (5.4)51 (7.8)
Loop type23 (2)8 (1.6)15 (2.2)
Total1158490668

The relationship between Cambridge classification and the distribution of the course types, ductal configuration types of main pancreatic duct, pancreas divisum subtypes

Cambridge 1; n - (%)Cambridge 2 and 3; n - (%)Cambridge 4; n - (%)Cambridge 5; n - (%)TOTAL n - (%)
Descending type612 (85)82 (11)25 (3)5 (1)724 (62.5)
Sigmoid type292 (85)34 (10)13 (4)4 (1)343 (30)
Vertical type57 (84)7 (10)3 (4)1 (2)68 (5.5)
Loop type17 (74)4 (17)2 (9)0 (0)23 (2)
TOTAL978 (85)127 (11)43 (4)10 (1)1158 (100)
Type 1445 (85)54(10)18 (4)4 (1)521 (45)
Type 234 (81)6 (14)2 (5)0 (0)42 (3.6)
Type 3447 (84)57 (11)19 (4)5 (1)528 (45.6)
Type 444 (81)8 (15)2 (4)0 (0)54 (4.6)
Type 58 (62)2 (15)2 (15)1 (8)13 (1.2)
TOTAL978 (85)127 (11)43 (4)10 (1)1158 (100)
PD subtype 119 (79)4 (17)1 (4)0 (0)24 (44.4)
PD subtype 216 (80)3 (15)1 (5)0 (0)20 (37)
PD. subtype 39 (90)1 (10)0 (0)0 (0)10 (18.6)
TOTAL FOR PD44 (81)8 (15)2 (4)0 (0)54 (100)

MRI sequence parameters

TRTEMATRIXN OF SLICESLICE THICKNESSFOVNSATSE-TFE FACTORSLAB THICK
T2 W Images (Ax and Coronal)962ms100 ms256x256246 mm350-400 mm2158-
GRE Balanced TFE (Ax and Coronal)4 ms1.24 ms156x213247 mm300-400 mm2219-
3D-TSE T2 W respiratory-triggered1466 ms650 ms256x25610.8 mm250-300 mm110540 mm
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Temas de la revista:
Medicina, Medicina Clínica, Radiología, Medicina Interna, Hematología, oncología
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