The Study Of Multi-slice CT In Diagnosis And Resectable Assessing Of Pancreatic Carcinoma

Part I Multi-slice helical CT: Multi-phase protocol for the pancreatic carcinomaObjective: To study the multi-phase protocol for the evaluation of pancreatic carcinoma by using multi-slice helical CT. Materials and methods: Eighty patients with a normal-appearing pancreas but were suspected of having pancreatic abnormality and 68 patients with proved pancreatic carcinoma underwent multi-phase, contrast-enhanced, multi-slice helical CT during the arterial phase, pancreatic parenchymal phase, and portal venous phase. Attenuation value of the normal pancreas, pancreatic carcinoma, and the tumor-to-pancreas contrast difference, and arteries or venous of pro-pancreas were measured during all three imaging phases. The maximum diameter of the small peri-pancreatic veins were measured, the display rate of the small peri-pancreatic veins was calculated in normal and abnormal group. Quantitative analysis of these measurements and subjective qualitative analysis of tumor conspicuity were performed. Results: Maximal enhancement of the normal pancreatic parenchyma occurred during the pancreatic parenchyma phase. Maximal tumor-to-pancreas attenuation differences during the pancreatic parenchyma phase, maximal arterial enhancement was seen during the arterial phase, and maximal venous enhancement was seen during the pancreatic parenchyma phase and portal phase. The display rate of the small peripancreatic veins was higher in the normal group than the abnormal group. Subjective analysis revealed that the tumor conspicuity during the pancreatic parenchyma phase was superior to that during the arterial phase and portal phase. Conclusions: In the multi-phase protocol for pancreas by using multi-slice helicalCT, multi-phase include arterial phase, pancreatic parenchyma phase, and portal phase may be the perfect protocol, it may be helpful for detection of the tumor, and dual phase angiography can performed with this protocol.Objective: To evaluation the efficacy of dual-phases angiography of pancreas with multi-slice helical CT and compare the three dimensional reconstruction techniques. Materials and Methods: 46 cases with suspected pancreatic carcinoma were performed on multi-slice helical CT. Scan parameters including collimation 2.5mm, thickness3~5mm, pith 5, each phase takes 6~9s. 3D CTA of arterial phase and portal venous phase were reconstructed, three dimensional reconstruction techniques include volume rendering technique (VR), maximum intensity projection (MIP), shaded surface display (SSD), were adapted. Stat the arteries or venous which displayed on the 3D images separately. Results: On arterial phase, the total display rate of celiac artery, superior mesenteric artery and gastroduodenal artery that reconstructed with VR, MIP and SSD were 96.9%, 96.9% and 84.8% respectively. Portosystemic vessels of normal and abnormal were all demonstrated on portal venous phase, the total display rate of normal main branch of portal vein, splenic vein, superior mesenteric vein which reconstructed with VR, MIP and SSD were 100%, 100% and 81.8%. Conclusion: Dual-phases angiography of pancreas with multi-slice helical CT is a non-invasive method of depicting arteries and portosystemic vessels, VR is superior to MIP and SSD, and can provide more information of pre-pancreatic vessels for clinic.Objective: The purpose of this study was to test the accuracy of multi-slice helical CT (MSCT) dual-phase angiography in prediction of vascular involvement from pancreatic cancer and correlate the resultant images with findings at surgery. Materials and Methods: Multi-slice helical CT dual-phase angiography was done in 68 patients who had pancreatic carcinoma. Three dimensional volume rendering technique was adapted. Vessel integrity of the celiac artery, superior mesenteric artery, superior mesenteric vein, and portal vein were assessed on a 5-grade scale prospectively on both axial MSCT scans and MSCT angiograms and correlated with findings at surgery. t-test was used for the difference of the grade of vessels invasion in axial...