A prospective evaluation of computed tomography and ultrasound of the pancreas.

Abstract

A prospective cooperative study was performed to assess the relative efficacy of computed tomography (CT) and ultrasound in detecting and identifying pancreatic lesions. Of the 279 patients in the study, 146 were found to have a normal pancreas, and 133 had an abnormal pancreas. All patients underwent both CT and ultrasound examinations. Forty-four ultrasound examinations were technically unsatisfactory. When these suboptimal examinations were excluded, CT had a sensitivity of 0.87 and a specificity of 0.90 in detecting an abnormal pancreas. Ultrasound had a sensitivity of 0.69 and a specificity of 0.82. In detecting a lesion and identifying it as malignant or inflammatory, CT had a sensitivity of 0.84 and ultrasound had a sensitivity of 0.56. It is concluded that CT is the method of choice for detecting a pancreatic lesion, assessing its extent, and defining its etiology.

Pancreatic Cancer: Imaging Sensitivity and Survival

“…Our study indicated that US scanning has achieved a sensitivity approaching that of CT scanning in detecting pancreatic carcino mas, which is in contrast to other reports [8,9] (table I). Superior equipment (installation of a real-time scanner in 1979) and the accu mulated interpretative skills of our radiolo gists probably account for this increased sen sitivity.…”

Improved Survival for Patients with Pancreatic Abscess

“…Patients with severe pancreatitis or pancreatic abscess typically have an adynamic ileus, and overlying bowel gas makes ultrasonographic visualization of the pancreas difficult. Technical problems with ultrasound are also common in obese patients [6,7,13]. The differ entiation between pancreatic abscess and pseudocyst is often troublesome, an issue not uniformly resolved with CT scans.…”

“…Ultrasound and computed tomography (CT) have been the most useful for visualization of the pancreas and lesser omental sac [6,7]. With these newer methods, the diagnosis of pan creatic abscess should be made with greater accuracy allowing earlier surgical intervention and a correspond ing decrease in mortality from earlier studies.…”

Evaluation of En Bloc Radical Pancreatectomy for Carcinoma of the Head of the Pancreas Involving the Adjacent Vessels

“…Recent advances in diagnostic aids, such as computerized tomography, ultrasonogra phy, endoscopy, and angiography, now allow a relatively accurate distinction between abnormal lesions and nor mal tissue in the pancreas [2][3][4], However, since the early symptoms of carcinoma of the pancreas are both vague and nonspecific, in most cases the diagnosis is made only in the advanced stage [5], In our series 64.6% (124/192) of the carcinoma of the head of the pancreas were unresectable because of dissemination, hepatic metastasis, or blood vessel involvement at the time of surgery. 2 Fig.…”