Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5 T.

Abstract

A prospective comparison of computed tomography (CT) and magnetic resonance (MR) imaging at 1.5 T was performed in 50 patients with the suspected diagnosis of pancreatic carcinoma. CT scans were obtained before and after administration of contrast material in 41 of 50 patients (82%); 34 of 41 postcontrast scans (83%) were obtained with dynamic CT. MR images were interpreted without knowledge of the results of CT, ultrasound, cholangiography, or endoscopic retrograde cholangiopancreatography in 48 patients (96%). Surgical correlation of findings at CT and MR imaging was performed in 24 patients (48%) at laparotomy and in two patients (4%) at autopsy. On T1-weighted MR images, relatively diminished signal intensity of tumor compared with that of the adjacent pancreas was a consistent finding. MR imaging proved superior to CT in identification of pancreatic carcinoma (particularly in smaller intrapancreatic tumors), peripancreatic extension, vascular and portal vein invasion, and duodenal invasion. These results suggest that MR imaging of the pancreas is superior in many instances to CT in preoperative evaluation of pancreatic carcinoma.

Power Doppler ultrasonography for the assessment of vascular invasion by pancreatic cancer

“…In PV invasion, the diagnostic accuracy of CT scans has been reported to be between 73 and 93% [9,10,12]. However, subtle PV invasion is difficult to detect by CT scan, and the sensitivity is reported to be between 25 and 83% [9,10,19].…”

“…In terms of diagnostic accuracy of arterial invasion, the CT scan was not good, ranging from 13 to 72% [9,21]. The low rate of detection of arterial invasion by CT was due to difficulties in resolving images of tortuous arteries.…”

“…Arterial invasion and/or complete encasement of the PV were not indicated for resection. Although the traditional diagnostic modality for vascular invasion was angiography, CT scan, MRI, and endoscopic ultrasonography were reported to show promising results in the staging of pancreatic cancer [8][9][10].…”

New Imaging Techniques in the Evaluation of Gastrointestinal Diseases

“…Pancreatic neoplasms: While CT has been the imaging modality of choice in routine clinical evaluations of pancreatic neoplasms, newer MRI sequences have been shown to be superior in both detecting and defining local tumour extension. Studies have found the sensitivity for tumour detection to be 69% to 74% for CT and 83% to 87% for MRI (60,61). For tumours smaller than 3 cm, MRI had a sensitivity of 67%, and CT had a sensitivity of 53% (60).…”

Pankreaskarzinom: Welche Faktoren bestimmen die Resektabilität?

“…Die MRT-Untersuchung wird noch nicht regelma Èûig fu È r die pra Èoperative Pankreasdiagnostik angewandt, da der Vorteil gegenu È ber der CT noch nicht gezeigt werden konnte. In einigen Studien konnte mittels MRT der Tumor selbst sowie dessen extrapankreatische Manifestationen (Infiltration der Duodenal-und Gefa Èû-wa Ènde) besser als mit CT dargestellt werden [24]. Der Befall von Lymphknoten galt lange Zeit als Kontraindikation fu È r eine chirurgische Intervention.…”