ISSN:
1432-2102
Keywords:
Schlüsselwörter Pankreaskarzinom
;
Staging
;
Gefäßinfiltration
;
Spiral-CT
;
Magnetresonanztomographie
;
Key words Pancreatic carcinoma
;
Staging
;
Vascular involvement
;
Spiral computed tomography
;
Magnetic resonance imaging
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Description / Table of Contents:
Summary The purpose of this study was to assess the role of spiral computed tomography (SCT) and magnetic resonance imaging (MRI) in the preoperative work-up of patients with pancreatic carcinoma, regarding local resectability and vascular involvement. Methods and materials: A total of 28 patients (19 men and 9 women; mean age 58 years) with known or highly suspected carcinoma of the pancreas were included in this study. All patients prospectively underwent MRI (± gadolinium-DTPA) and SCT (3-phase examination) as preoperative diagnostic imaging studies, and laparotomy was carried out within 7 days, irrespective of the MRI or SCT findings. SCT and MR studies were reviewed independently by two radiologists, without knowing the results of the surgical exploration. Standardized image analysis was correlated with findings at laparatomy. Results: Laparotomy identified 10 patients to be suitable for surgical resection and 18 pancreatic carcinomas to be unresectable. In 17 of 18 non-resectable carcinomas MRI and SCT were able to obtain correct information about unresectability (sensitivity 94 %), in 7 (MRI), resp. 8 (SCT) carcinomas were correctly considered to be resectable (sensitivity 70 % for MRI and 80 % for SCT). The presence of vascular involvement was depicted by SCT with a sensitivity of 82–100 % and 62–100 % by MRI. The specificity varied between 85–100 % for SCT and 77–100 % for MRI. Conclusion: Both MRI and SCT are good techniques for the preoperative work-up of pancreatic carcinomas in order to obtain a correct assessment of local resectability.
Notes:
Zusammenfassung Das Ziel der vorliegenden Untersuchung an 28 Patienten war die Bestimmung der Wertigkeit der Spiralcomputertomographie (Spiral-CT) und der Magnetresonanztomographie (MRT) im präoperativen Staging des Pankreaskarzinoms. Dazu wurde vergleichend die Infiltration peripankreatischer arterieller und venöser Gefäßstrukturen analysiert. Die Befunde wurden mit dem Ergebnis der Laparotomie korreliert, der alle Patienten unabhängig von den Ergebnissen der Spiral-CT und der MRT unterzogen wurden. Zur präoperativen Bestimmung der lokalen Ausdehnung von Pankreaskarzinomen und damit der Operabilität sind sowohl die 3-Phasen-Spiral-CT und die MRT (± Gadolinium-DTPA) gleichermaßen geeignete Untersuchungsmethoden. Insbesondere können beide Untersuchungsverfahren die Infiltration benachbarter vaskulärer Strukturen präoperativ mit hoher Genauigkeit nachweisen und somit die Planung des operativen Vorgehens beeinflussen.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001170050089
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