Aim of work: To determine the role of Multi-detector Computed Tomography in the evaluation of various pancreatic lesions. Background:MDCT with its thin collimation allows three-dimensional reformatting and multiplanar reconstruction of pancreatic anatomy which permits good depictions of many pancreatic lesions. Patients and Methods:30 patients with pancreatic lesions suspected on the basis of clinical symptoms, laboratory investigations and USS findings were enrolled in this study. Majority of patients (2 patients were fellow-up patients) were subjected to full clinical history, general and abdominal examination, Laboratory investigations, Ultrasonography examinations with (Siemens, Acuson.X300), and CT examinations; Triphasic contrastenhanced and monophasic MDCT (with delay of 40-50s) performed on (Philips, Ingenuity core128-multislice CT) in the Zagazig university hospital. Results:This study included 30 patients with suspected pancreatic lesions. They were 19 males (63.4%) and 11 females (34.6%). The most studied patients were above 50 years. 11 patients were diagnosed with acute pancreatitis, one patient with acute on chronic pancreatitis, and 18 patients with pancreatic neoplasms. Hence, pancreatic neoplasms were found to be the most common pancreatic lesions in our study. Conclusion:MDCT with contrast proved to be the imaging modality of choice in identification of various pancreatic lesions. The faster scanning time (with single breath hold) and thin slice thickness, allowed for better resolution and superior scan quality. The ability of MDCT to scan in both arterial and venous phases with its post processing techniques (MIP, MinP, CRP, and VR) allowed for excellent visualization of the pancreas, biliary anatomy and peripancreatic vasculature.
Background: Obstructive Jaundice is a common surgical problem, MultiDetector Computed Tomography in diagnosis of biliary tract obstruction has a vital role as post processing techniques can be utilized to identify variant biliary anatomy to guide preoperative biliary surgery planning, determine level and cause of obstruction, early tumor detection and staging of biliary cancer are the key factors for possible cure by surgical resection, our aim is to evaluate the role of MDCT in diagnosing level and cause of biliary obstruction. Patients and Methods: Sixty nine patients with clinically suspected biliary obstruction were encountered in the study and subjected to clinical assessment including full history taking, clinical examination and imaging assessment by MDCT, our findings were correlated to standard reference examinations including: Operative/ERCP/Biopsy and histopathology findings. Results: Our results showed that the most affected age group was group between 60: <70 years old, males were affected more than females. The most common clinical presentation in our patients was yellowish discoloration of the skin and sclera followed by biliary colic. Right hypochondrial tenderness was the main clinical finding on clinical examination in our study. Our patients were categorized according to the cause of biliary obstruction into seven groups: Malignant stricture group 52.2% (36patients), Calcular group 24.6% (17patients), Iatrogenic group 5.8% (4patients), Porta hepatis lesions group 5.8% (4patients), Benign stricture group 4.3% (3patients), Inflammatory group 4.3% (3patients), Congenital group 1.4% (1patient). Conclusions: MultiDetector computed tomography provides a modality with high diagnostic performance for differentiating benign from malignant lesions and in detecting biliary calculi.
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