The “Duct-penetrating sign” in inflammatory pancreatic mass

Abstract

The “Duct-penetrating sign” is an important radiological finding of inflammatory pancreatic masses (mass-forming chronic pancreatitis, MFCP) and help to distinguish the MFCP from pancreatic carcinoma (Figs. 1 and 2) [1]. The “Duct-penetrating sign” defines a non-obstructed, smoothly stenotic or normal-appearing main pancreatic duct penetrating a pancreatic mass on magnetic resonance cholangiopancreatography (MRCP) [1]. The “Duct-penetrating sign” on MRCP has been shown to be more helpful (with a higher sensitivity and specificity) than contrast-enhanced abdominal computed tomography (CT) and magnetic resonance imaging (MRI) to distinguish the inflammatory pancreatic masses from pancreatic carcinoma [2]. The “Duct-penetrating sign” on MRCP is a highly specific finding of inflammatory pancreatic masses (85%) but they can also be seen in pancreatic carcinoma (4%). However, the abrupt cutoff of the main pancreatic duct and the presence of the double-duct sign (obstruction and cutoff of both the main pancreatic duct and the common bile duct) are highly specific finding of pancreatic carcinoma