The Accuracies of Diagnosing Pancreas Divisum by Magnetic Resonance Cholangiopancreatography and Endoscopic Ultrasound: A Systematic Review and Meta-analysis

Overview

Journal Sci Rep

Specialty Science

Date 2016 Oct 14

PMID 27734952

Citations 10

Authors

Zhe Shen

Stefan Munker

Boyan Zhou

Lin Li

Chaohui Yu

Youming Li

Affiliations

Soon will be listed here.

Abstract

Magnetic resonance cholangiopancreatography (MRCP), MRCP after secretin stimulation (S-MRCP) and endoscopic ultrasonography (EUS) are all selected to diagnose pancreas divisum. However, the accuracies of three diagnosis remain unclear. The aim is to address the diagnostic accuracies of MRCP, S-MRCP and EUS on pancreas divisum. We searched PubMed, MEDLINE and EMBASE databases from inception to January, 2015. Of the 536 citations retrieved, 16 studies were included. For MRCP diagnosis on pancreas divisum, the area under the hierarchical summary receiver-operating characteristic (HSROC) curve was 0.90 (95% confidence interval [CI] 0.87 to 0.92), and for S-MRCP and EUS, 0.99 (95% CI 0.97 to 0.99) and 0.97 (95% CI 0.96 to 0.98). Sensitivity and specificity for MRCP were 0.59 (95% CI 0.45 to 0.71) and 0.99 (95% CI 0.96 to 1.00); for S-MRCP, 0.83 (95% CI 0.66 to 0.92) and 0.99 (95% CI 0.96 to 1.00); for EUS, 0.85 (95% CI 0.67 to 0.94) and 0.97 (95% CI 0.90 to 0.99). Comprehensive comparison of three diagnostic techniques to pancreas divisum, S-MRCP was more reliable than MRCP and EUS on the effect of the diagnostic test.

Citing Articles

Early Chronic Pancreatitis Findings by Endoscopic Ultrasonography (EUS) in Asymptomatic Patients with Pancreas Divisum.

Nagahama M, Takano Y, Niiya F, Tamai N, Noda J, Yamawaki M Diagnostics (Basel). 2025; 15(3).

PMID: 39941183 PMC: 11817992. DOI: 10.3390/diagnostics15030253.

Pancreas divisum unmasked: a case report.

Zouaki I, Jarti M, Sadik A, Nacir O, Lairani F, Aiterrami A Pan Afr Med J. 2025; 49():48.

PMID: 39867551 PMC: 11760208. DOI: 10.11604/pamj.2024.49.48.45004.

Refractory postoperative pancreatic fistula following laparoscopic distal pancreatectomy for pancreatic cancer caused by incomplete pancreas divisum: a case report.

Funamizu N, Uraoka M, Numata Y, Koizumi M, Ogawa K, Ikeda Y Clin J Gastroenterol. 2024; 17(3):587-591.

PMID: 38460085 DOI: 10.1007/s12328-024-01942-x.

Endoscopic Ultrasound in Pancreatic Duct Anomalies.

Chatterjee A, Rana S Diagnostics (Basel). 2023; 13(19).

PMID: 37835872 PMC: 10572994. DOI: 10.3390/diagnostics13193129.

Pancreas divisum causing recurrent pancreatitis in a young patient: A case report.

Belabbes F, Mounsif S, Faquir N, Cherkaoui Jaouad M, Habi J, Rouibaa F Radiol Case Rep. 2023; 18(10):3535-3538.

PMID: 37547796 PMC: 10400807. DOI: 10.1016/j.radcr.2023.07.028.

References

Soto J, Barish M, Yucel E, Clarke P, Siegenberg D, Chuttani R . Pancreatic duct: MR cholangiopancreatography with a three-dimensional fast spin-echo technique. Radiology. 1995; 196(2):459-64. DOI: 10.1148/radiology.196.2.7617861. View

Manfredi R, Costamagna G, Brizi M, Maresca G, Vecchioli A, COLAGRANDE C . Severe chronic pancreatitis versus suspected pancreatic disease: dynamic MR cholangiopancreatography after secretin stimulation. Radiology. 2000; 214(3):849-55. DOI: 10.1148/radiology.214.3.r00mr24849. View

Tandon M, Topazian M . Endoscopic ultrasound in idiopathic acute pancreatitis. Am J Gastroenterol. 2001; 96(3):705-9. DOI: 10.1111/j.1572-0241.2001.03609.x. View

Stern C . A historical perspective on the discovery of the accessory duct of the pancreas, the ampulla 'of Vater' and pancreas divisum. Gut. 1986; 27(2):203-12. PMC: 1433212. DOI: 10.1136/gut.27.2.203. View

Kamisawa T, Tu Y, Egawa N, Tsuruta K, Okamoto A, Kamata N . MRCP of congenital pancreaticobiliary malformation. Abdom Imaging. 2006; 32(1):129-33. DOI: 10.1007/s00261-006-9005-3. View

Begg C, Mazumdar M . Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994; 50(4):1088-101. View

Kushnir V, Wani S, Fowler K, Menias C, Varma R, Narra V . Sensitivity of endoscopic ultrasound, multidetector computed tomography, and magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum: a tertiary center experience. Pancreas. 2012; 42(3):436-41. PMC: 3928633. DOI: 10.1097/MPA.0b013e31826c711a. View

Harbord R, Egger M, Sterne J . A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints. Stat Med. 2005; 25(20):3443-57. DOI: 10.1002/sim.2380. View

Lai R, Freeman M, Cass O, Mallery S . Accurate diagnosis of pancreas divisum by linear-array endoscopic ultrasonography. Endoscopy. 2004; 36(8):705-9. DOI: 10.1055/s-2004-825663. View

10.

Klein S, Affronti J . Pancreas divisum, an evidence-based review: part II, patient selection and treatment. Gastrointest Endosc. 2004; 60(4):585-9. DOI: 10.1016/s0016-5107(04)01896-6. View

11.

Ueno E, Takada Y, Yoshida I, Toda J, Sugiura T, Toki F . Pancreatic diseases: evaluation with MR cholangiopancreatography. Pancreas. 1998; 16(3):418-26. View

12.

Matos C, Metens T, Deviere J, Nicaise N, Braude P, Van Yperen G . Pancreatic duct: morphologic and functional evaluation with dynamic MR pancreatography after secretin stimulation. Radiology. 1997; 203(2):435-41. DOI: 10.1148/radiology.203.2.9114101. View

13.

Carnes M, Romagnuolo J, Cotton P . Miss rate of pancreas divisum by magnetic resonance cholangiopancreatography in clinical practice. Pancreas. 2008; 37(2):151-3. DOI: 10.1097/MPA.0b013e318164cbaf. View

14.

Satterfield S, McCarthy J, GEENEN J, Hogan W, Venu R, Dodds W . Clinical experience in 82 patients with pancreas divisum: preliminary results of manometry and endoscopic therapy. Pancreas. 1988; 3(3):248-53. DOI: 10.1097/00006676-198805000-00002. View

15.

Moffatt D, Cote G, Avula H, Watkins J, McHenry L, Sherman S . Risk factors for ERCP-related complications in patients with pancreas divisum: a retrospective study. Gastrointest Endosc. 2011; 73(5):963-70. DOI: 10.1016/j.gie.2010.12.035. View

16.

Repiso Ortega A, Gomez-Rodriguez R, Romero M, Fernandez-Zapardiel S, Cespedes M, Carrobles J . Prospective comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the etiological diagnosis of "idiopathic" acute pancreatitis. Pancreas. 2011; 40(2):289-94. DOI: 10.1097/MPA.0b013e318201654a. View

17.

Wang F, Gatsonis C . Hierarchical models for ROC curve summary measures: design and analysis of multi-reader, multi-modality studies of medical tests. Stat Med. 2007; 27(2):243-56. DOI: 10.1002/sim.2828. View

18.

Park D, Kim M, Lee S, Lee S, Kim K, Han J . Accuracy of magnetic resonance cholangiopancreatography for locating hepatolithiasis and detecting accompanying biliary strictures. Endoscopy. 2004; 36(11):987-92. DOI: 10.1055/s-2004-825812. View

19.

Mosler P, Akisik F, Sandrasegaran K, Fogel E, Watkins J, Alazmi W . Accuracy of magnetic resonance cholangiopancreatography in the diagnosis of pancreas divisum. Dig Dis Sci. 2011; 57(1):170-4. DOI: 10.1007/s10620-011-1823-7. View

20.

Whiting P, Rutjes A, Reitsma J, Bossuyt P, Kleijnen J . The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003; 3:25. PMC: 305345. DOI: 10.1186/1471-2288-3-25. View