Abstract
A prospective study was designed to determine the utility of computed tomography (CT) during arterial portography (CTAP) in the detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma. Eighteen patients with adenocarcinoma of the head of the pancreas and eight patients with benign pancreatic disease were investigated with CTAP, dynamic contrast-enhanced CT, and angiography. Appropriate review was made to determine presence or absence of superior mesenteric vessels and portal vein involvement. Final diagnosis was obtained in all cases by surgical explorations. The overall accuracy rate for detecting or excluding superior mesenteric vessels and portal vein involvement was 96% (25 of 26 patients) with CTAP, 88% (23 of 26 patients) with dynamic contrast-enhanced CT, and 85% (22 of 26 patients) with angiography. No statistically significant difference in accuracy was found among the three techniques. Our results suggest that the use of CTAP is not indicated in the preoperative detection of superior mesenteric vessels and portal vein involvement in patients with pancreatic adenocarcinoma.
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References
Megibow AJ. Pancreatic adenocarcinoma: designing the examination to evaluate the clinical questions. Radiology 1992;183:297–303
Warshaw AL, Gu Z, Wittenberg J, Waltman AC. Preoperative staging and assessment of resectability of pancreatic cancer. Arch Surg 1990;125:230–233
Trede M. The surgical treatment of pancreatic carcinoma. Surgery 1985;97:8–35
Michelassi F, Erroi F, Dawson PJ, et al. Experience with 647 consecutive tumors of the duodenum, ampulla, head of the pancreas, and distal common bile duct. Ann Surg 1989;210:544–556
Rosenberg JM, Welch JP, Macauley WP. Cancer of the head of the pancreas: an institutional review with emphasis on surgical therapy. J Surg Oncol 1985;28:217–221
Howard JM, Jordan GL Jr. Cancer of the pancreas. Curr Probl Cancer 1977;2:5–52
Itai Y, Araki T, Taraka A, Maruyama M. Computed tomography appearances of resectable pancreatic carcinoma. Radiology 1982;143:719–726
Ward EM, Stephens DH, Sheedy PR. Computed tomographic characteristics of pancreatic carcinoma: an analysis of 100 cases. Radiographies 1983;3:547–565
Jafri SZH, Alsen AM, Glazer GM, Weiss CA. Comparison of CT and angiography in assessing resectability of pancreatic carcinoma. AJR 1984;142:525–529
Freeny PC, Marks WM, Ryan JA, Traverso LW. Pancreatic ductal adenocarcinoma: diagnosis and staging with dynamic CT. Radiology 1988;166:125–133
Ross CB, Sharp KW, Kaufman AJ, Andrews T, William LF. Efficacy of computerized tomography in the preoperative staging of pancreatic carcinoma. Am Surg 1988;54:221–226
Balthazar EJ, Chako AC. Computed tomography of pancreatic masses. Am J Gastroenterol 1990;85:343–349
Soyer P, Roche A, Gad M, et al. Preoperative segmental localization of hepatic metastases: utility of three-dimensional CT during arterial portography. Radiology 1991;180:653–658
Widrich WC, Nordahl DL, Robbins AH. Contrast enhancement of the mesenteric and portal veins using intra-arterial papaverine. AJR 1974;121:374–379
Hall-Craggs NA, Lees WR. Fine-needle aspiration biopsy: pancreatic and biliary tumors. AJR 1986;147:399–403
Bornman PC, Harries-Jones EP, Tobias R, Stiegmann GV, Terblanche J. Prospective controlled trial of transhepatic biliary endoprosthesis versus bypass surgery for incurable carcinoma of the pancreas. Lancet 1986;1:69–71
Fernandez-del Castillo C, Warshaw AL. Diagnosis and preoperative evaluation of pancreatic cancer with implications for management. Gastroenterol Clin North Am 1990;19:915–933
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Soyer, P., Lacheheb, D., Belkacem, A. et al. Involvement of superior mesenteric vessels and portal vein in pancreatic adenocarcinoma: Detection with CT during arterial portography. Abdom Imaging 19, 413–416 (1994). https://doi.org/10.1007/BF00206927
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DOI: https://doi.org/10.1007/BF00206927