Utility of MSCT reconstruction in preoperative evaluation of pancreatic carcinoma / 中华胰腺病杂志

ABSTRACT

Objective To investigate the value of multi slice spiral computed tomography (MSCT) reconstruction technique for diagnosis and preoperative evaluation of pancreatic carcinoma.Methods The multi-phase enhanced CT images of thirty-five cases of pancreatic carcinoma proved histologically were analyzed retrospectively.The techniques of volume rendering (VR),multi-planar reconstruction (MPR) and curved planar reformation (CPR) were used to deal with the images,and the relation between the pancreatic tumor and its surrounding structures,vessels,bile duct were observed,then the evaluation of possible surgical resection was performed,then it was compared with operative results.Results Among the 35 patients,27 vessels invasion was showed in 9 patients,common bile duct invasion in 19 patients,pancreatic duct invasion in 12 patients,duodenum invasion in 7 patients,posterior wall of stomach in 2 patients was invaded; one patient had regional portal hypertension with splenomegaly,peri-pancreatic lymph nodes enlargement was detected in 14 patients,para-aortic lymph nodes enlargement was detected in 4 patients,and liver metastasis was found in 3 patients.According to CT evaluation,surgery could be performed in 21 cases,finally 19 patients underwent curative pancreatic cancer resection,and 2 patients underwent palliative surgery.According to CT evaluation,surgery could not be performed in 14 cases,and all of the patients underwent palliative surgery.The coincidence percentage of pre-operative evaluation and post-operative results of curative surgery,palliative surgery was 90％ and 88％.Conclusions MSCT reconstruction technique is useful for diagnosis of pancreatic carcinoma regional invasion and metastasis,and it can increase the accuracy of assessment of tumor resectability.