Analysis of the appearances of multiple MRI sequences and the assessment of resectability in caput pancreatic carcinoma / 重庆医科大学学报

ABSTRACT

Objective:To analyze the appearances of multiple MRI sequences and the accuracy of the assessment of resectability in caput pancreatic carcinoma.Methods:MRI appearances were analyzed retrospectively in nineteen patients with histopathology or clinical examination proved carcinoma in the head of pancreas,and the assessment of resectability was compared with the findings of surgical and histopathology.Plain MRI sequences includedcoronal scanning with T2-weighted 2D true-fast imaging with steady-state free precession,axial scanning using T1-weighted fast low angle single shot with fat suppression,T2-weighted half-Fourier single shot turbo spin-echo with fat suppression,and MRI cholangiopancreatography.The contrast-enhanced scanning procedures were axial scanning using T1-weighted 3D volume interpolated breathhold examination with fat suppression,the imaging were obtained during arterial phase,portal vein and delayed phase scanning.Results:Of 19 lesions in these patients,17 lesions showed hypo-intensity on T1WI of plain sequences,and normal pancreats showed hyper-intensity.15 lesions showed hyper-intensity or immingled-intensity on T2WI,one appended with cyst.During pancreatic arterial phase,18 lesions did not show enhancement,contrasting with the normal pancreas showing evidently enhancement,so the borderline of carcinoma was clear.During portal vein and delayed phase,17 lesions showed inhomogeneous slight enhancement,peripheral vas of pancreas in 17 cases were contacted or involved by tumor.3 transfer lesions in hepar showed slight enhancement.13 cases showed dilatation at both common bile duct and pancreatic duct as a typical double duct sign on MRCP.According to the assessment of MRI,7 cases could be resected,and 12 cases could not be resected.The assessment of 14 cases agreed with the surgical and histopathological findings.Conclusion:Carcinoma of pancreatic head is shown with many features on multiple MRI sequences.MRI examination has a high accuracy for the diagnosis and the assessment of resectability in carcinoma of pancreatic head,which is helpful in choosing project of therapy.