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Pancreatic adenocarcinoma: the different CT criteria for peripancreatic major arterial and venous invasion.
- 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.
- Subjects :
- Adult
Aged
Biopsy, Fine-Needle
Carcinoma, Pancreatic Ductal diagnostic imaging
Carcinoma, Pancreatic Ductal pathology
Carcinoma, Pancreatic Ductal surgery
Celiac Artery diagnostic imaging
Celiac Artery pathology
Celiac Artery surgery
Drainage
Female
Hepatic Artery diagnostic imaging
Hepatic Artery pathology
Hepatic Artery surgery
Humans
Jaundice diagnostic imaging
Jaundice pathology
Jaundice surgery
Male
Mesenteric Artery, Superior diagnostic imaging
Mesenteric Artery, Superior pathology
Mesenteric Artery, Superior surgery
Mesenteric Vascular Occlusion diagnostic imaging
Mesenteric Vascular Occlusion pathology
Mesenteric Vascular Occlusion surgery
Mesenteric Veins diagnostic imaging
Mesenteric Veins pathology
Mesenteric Veins surgery
Middle Aged
Neoplasm Invasiveness pathology
Neoplasm Staging
Palliative Care
Pancreas diagnostic imaging
Pancreas pathology
Pancreatic Neoplasms pathology
Pancreatic Neoplasms surgery
Portal Vein diagnostic imaging
Portal Vein pathology
Portal Vein surgery
Prognosis
Radiography
Vascular Neoplasms diagnostic imaging
Vascular Neoplasms pathology
Vascular Neoplasms surgery
Carcinoma, Pancreatic Ductal secondary
Pancreas blood supply
Pancreatic Neoplasms diagnostic imaging
Vascular Neoplasms secondary
Subjects
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