Introduction
Pancreatic main duct dilation (PMDD) may indicate an increased risk of developing pancreatic cancer. Little is known about the prevalence and natural course of PMDD in the general population. Therefore, this study aimed to analyse PMDD using magnet resonance imaging (MRI).
Aims & Methods
Longitudinal MRI combined with magnetic resonance cholangiopancreatography was performed between 2008 and 2021 as part of the prospective population-based Study of Health in Pomerania (SHIP), with 2,2 ± 0,6 MRI per participant on average performed within an average of 10,8 ± 1,2 yrs. PMDD was defined as ≥ 5 mm, and was correlated with clinical and epidemiological data.
Results
The prevalence of PMDD was 81/2985 individuals (2.7%). The mean age of these was 55.1 ± 13.2 yrs. Cumulative 5 yr-incidence of newly developed PMDD was 1.1% (22/1935) and 3.0% (15/ 496) after 10 yrs. Poisson regression analysis revealed strong associated factors of PMDD: active smoking (PR 2.93), diabetes (PR 2.58) and frequent alcohol abuse (PR 1.78) After a median follow-up period of 4.5 years, pancreatic cancer and chronic pancreatitis were diagnosed more frequently in the PMDD group: 2/81 (2.5%) vs. 24/2904 (0.8%) and 8/81 (9.9%) vs. 46/2904 (1.6%). Pancreatic cancerspecific survival was lower in cases of PMDD (HR = 4.96 (95% CI 1.31–18.84)).
Conclusion
A PMDD ≥5 mm is a frequent incidental MRI finding in the general population (2.7%). The risk of malignant transformation was higher with PMDD (2.5%) than without (0.8%). Chronic pancreatitis was diagnosed four times as often than pancreatic cancer in follow-up.
References
[1] Schmitz D, Stenzinger A, Grützmann R, et al. The differential diagnosis and management of pancreatic cystic neoplasms. Dtsch Arztebl Int 2025;122(22): 617–22.
[2] John U, Greiner B, Hensel E, et al. Study of health in Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Sozial- Praventivmed € 2001;46(3):186–94.
[3] Aghdassi AA, Schauer B, Duscha D, et al. Comparability of size measurements of the pancreas in magnetic resonance imaging and transabdominal ultrasound. Clin Anat 2020;33(3):431–9.
[4] Volzke € H, Alte D, Schmidt CO, et al. Kohortenprofil: die Erforschung der Gesundheit in Pommern. Int J Epidemiol 2011;40(2):294–307.
[5] Hegenscheid K, Kühn JP, Volzke € H, Biffar R, Hosten N, Puls R. Whole-body magnetic resonance imaging of healthy volunteers: pilot study results from the population-based SHIP study. Rofo € 2009;181(8):748–59.
[6] Hosten N, Bülow R, Volzke € H, et al. SHIP-MR and radiology: 12 years of whole-body magnetic resonance imaging in a single center. Healthcare (Basel) 2021;10(1):33.
[7] Volzke € H, Schossow € J, Schmidt CO, et al. Cohort profile update: the study of health in Pomerania (SHIP). Int J Epidemiol 2022;51(6):e372–83.
Disclosure
All authors declare that they have no conflict of interest with regard to the content of the presented study