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Pancreatic adenocarcinoma: the different CT criteria for peripancreatic major arterial and venous invasion.

Authors :
Li H
Zeng MS
Zhou KR
Jin DY
Lou WH
Source :
Journal of computer assisted tomography [J Comput Assist Tomogr] 2005 Mar-Apr; Vol. 29 (2), pp. 170-5.
Publication Year :
2005

Abstract

Objective: To establish preliminarily the different diagnostic criteria for peripancreatic arterial and venous invasion in pancreatic carcinoma by comparing their multidetector-row computed tomography (MDCT) appearances with surgical exploration.<br />Methods: Among 101 patients with pancreatic carcinoma examined by MDCT, 54 candidates accepting surgery were preoperatively evaluated for vascular invasion based on CT signs (A-E): arterial embedment in tumor or venous obliteration; tumor involvement exceeding one-half of the circumference of the vessel; vessel wall irregularity; vessel caliber stenosis; teardrop superior mesenteric vein (SMV). The peripancreatic major vessels (n = 224) were examined carefully by surgeons during the operation.<br />Results: During surgical exploration, 78 vessels were found to be invaded. With sign A (B, C, or D) as the CT criterion for peripancreatic vascular invasion, the sensitivity of arterial and venous invasion was 66% (97%, 45%, or 41%) and 14% (49%, 63%, or 55%), respectively; the specificity of absence of arterial and venous invasion was 100% (91%, 99%, or 100%) and 100% (all 100%). In this study, there were 3 SMVs appearing teardrop (sign E), which were all confirmed to be invaded.<br />Conclusions: It is recommended that the CT diagnostic criteria for arterial and venous invasion should be dealt with differently. The criteria of arterial invasion are the presence of sign A or the combination of sign B with one of signs C and D. The criteria of venous invasion are the presence of one of the following signs: sign A, sign B, sign C, sign D, and sign E.

Details

Language :
English
ISSN :
0363-8715
Volume :
29
Issue :
2
Database :
MEDLINE
Journal :
Journal of computer assisted tomography
Publication Type :
Academic Journal
Accession number :
15772532
Full Text :
https://doi.org/10.1097/01.rct.0000155060.73107.83