Which imaging studies are indicated in the workup of Peutz-Jeghers syndrome (PJS)?

Updated: Oct 11, 2018
  • Author: Buu Anh T To, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Answer

Imaging studies in Peutz-Jeghers syndrome (PJS) include the following:

  • Upper gastrointestinal endoscopy
  • Capsule endoscopy
  • Magnetic resonance imaging (MRI) enteroclysis
  • Computed tomography (CT) scanning with oral contrast medium
  • CT enterography
  • Colonoscopy
  • Push enteroscopy
  • Intraoperative enteroscopy (IOE)
  • Double-balloon enteroscopy (DBE)
  • Endoscopic ultrasonography (EUS)
  • Endoscopic retrograde cholangiopancreatography (ERCP) [84]
  • Chest radiography or CT scanning in smokers [15]

Enteroclysis and dedicated small-bowel follow-through radiographs have traditionally been used to determine the presence and the location of small intestinal polyps in individuals with Peutz-Jeghers syndrome. CT enterography is accurate at detecting small polyps, especially those larger than 1 cm in diameter. [15]  Capsule endoscopy appears to be safe and as sensitive as barium enterography in the detection of significant small intestinal polyps in children with Peutz-Jeghers syndrome. [85]  Relatively more recently, MRI enterography has emerged as potentially superior to capsule endoscopy in the assessment of polyp size in adult patients with Peutz-Jeghers syndrome. [86]  

Imaging studies of the liver and the pancreas are indicated because of the risk of pancreatic cancer as well as of gallbladder polyps and cancer. These imaging studies may include ultrasonography and CT scanning with pancreatic details or magnetic resonance cholangiopancreatography (MRCP).


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