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Gastroenterology Research and Practice
Volume 2014 (2014), Article ID 765451, 9 pages
Review Article

The Utilization of Imaging Features in the Management of Intraductal Papillary Mucinous Neoplasms

1Radiodiagnostic and Radiotherapy Unit, University Hospital “Policlinico-Vittorio Emanuele”, Via Santa Sofia 78, 95123 Catania, Italy
2Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy
3Gastroenterology Unit, University Hospital “Policlinico-Vittorio Emanuele”, 95123 Catania, Italy

Received 28 March 2014; Revised 19 July 2014; Accepted 24 July 2014; Published 19 August 2014

Academic Editor: Niccola Funel

Copyright © 2014 Stefano Palmucci et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Intraductal papillary mucinous neoplasms (IPMNs) represent a group of cystic pancreatic neoplasms with large range of clinical behaviours, ranging from low-grade dysplasia or borderline lesions to invasive carcinomas. They can be grouped into lesions originating from the main pancreatic duct, main duct IPMNs (MD-IPMNs), and lesions which arise from secondary branches of parenchyma, denominated branch-duct IPMNs (BD-IPMNs). Management of these cystic lesions is essentially based on clinical and radiological features. The latter have been very well described in the last fifteen years, with many studies published in literature showing the main radiological features of IPMNs. Currently, the goal of imaging modalities is to identify “high-risk stigmata” or “worrisome feature” in the evaluation of pancreatic cysts. Marked dilatation of the main duct (>1 cm), large size (3–5 cm), and intramural nodules have been associated with increased risk of degeneration. BD-IPMNs could be observed as microcystic or macrocystic in appearance, with or without communication with main duct. Their imaging features are frequently overlapped with cystic neoplasms. The risk of progression for secondary IPMNs is lower, and subsequently an imaging based follow-up is very often proposed for these lesions.