Preoperative 3-phase contrast-enhanced multidetector-row computed tomography image in evaluating resectibility of pancreatic carcinoma: a comparison with postoperative pathological results

Abstract

Objective To evaluate the role of 3-phase contrast-enhanced multidetector-row computed tomography ( MDCT) in observing blood vessel invasion around the pancreas before operation and its value in assessing the resectibility of pancreatic carcinoma. Methods The 3-phase contrast-enhanced MDCT scanning images of 25 patients with pancreatic carcinoma were retrospectively analyzed. The intensity difference in 3 -phase contrast-enhanced MDCT scanning images between pancreatic carcinoma and normal pancreas and the involvement of major blood vessel were analyzed; the results were compared with those of operative finding. Results Seventeen patients had pancreatic carcinomas at the head of pancreas,six at the body of pancreas,and two at the tail of pancreas. The diameters of pancreatic carcinomas were ≤2 cm in two patients,and the others with diameter 2 cm. All the 25 patients were surgically treated,12 receiving pancreaticoduodenectomy and 13 receiving palliative surgery. Four ( 9 blood vessels) patients were misdiagnosed as unresectable and 3 ( 8 blood vessels) as resectable. The arterial phase of MDCT was helpful for observation of the blood vessel involvement and for performing computed tomographic arteriography ( CTA) ,which can better assess the tumor invasion of arteries around the pancreas. The largest intensity difference between normal pancreas and pancreatic carcinomas was found during the pancreatic phase,making it easier to discover pancreatic carcinoma. The largest intensity difference between liver and metastatic tumor was found in the liver phase,making it easier for qualitative diagnosis. Conclusion Three phase contrast-enhanced scanning with MDCT has great value for diagnosis of pancreatic carcinoma and for assessment of major blood vessel involvement. MDCT,together with other criteria,can help to assess the resectibility of tumor before operation.