PurposeThe purpose of the current study was to compare CT-signs of portal venous confluence infiltration for actual histopathological infiltration of the vein or the tumor/vein interface (TVI) in borderline resectable pancreatic ductal adenocarcinoma (PDAC).Methods and materials101 patients with therapy-naïve, primarily resected PDAC of the pancreatic head without arterial involvement were evaluated. The portal venous confluence was assessed for contour irregularity (defined as infiltration) and degree of contact. The sensitivity and specificity of contour irregularity versus tumor to vein contact >180° as well as the combination of the signs for tumor cell infiltration of the vessel wall or TVI was calculated. Overall survival (OS) was compared between groups.ResultsSensitivity and specificity of contour irregularity for identification of tumor infiltration of the portal venous confluence or the TVI was higher compared to tumor to vessel contact >180° for tumor cell infiltration (96%/79% vs. 91%/38% respectively, p<0.001). The combination of the signs increased specificity to 92% (sensitivity 88%). Patients with contour irregularity/ tumor to vein contact >180°/ both signs had significantly worse overall survival (16.2 vs. 26.5 months/ 17.9 vs. 37.4 months/ 18.5 vs. 26.5 months respectively, all p<0.05).ConclusionPortal venous confluence contour irregularity is a strong predictor of actual tumor cell infiltration of the vessel wall or the TVI and should be noted as such in radiological reports.

Glia-Choristom-Ein seltener Befund im Mittelohr Glial choristoma-An uncommon finding in the middle ear Anamnese Eine 65-jährige Frau stellte sich in unserer Praxis mit rezidivierenden Beschwerden am rechten Ohr vor. Sie gab an, seit 6 Jahren ein Druckgefühl und Otorrhö zu haben, Fieber oder Schmerzen wurden verneint. Zudem litt sie seit 1 Jahr unter intermittierenden Schwindelanfällen. Das linke Ohr war nicht betroffen. Vorherige Therapieversuche mittels Paukendrainageeinlagen durch ihren bisherigen HNO-Arzt hätten keine Besserung erzielt. Als Vorerkrankungen waren eine arterielle Hypertonie, eine Hypothyreose und ein Glaukom bekannt.

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