Pancreatic Carcinoma: Pre-operative Resectability Assessed By Spiral CT Angiography

IntrodutionPancreatic carcinoma is a common malignant gastrointestinal neoplasm. The prognosis for patients with pancreatic carcinoma remains extremely poor, with an overall 5-year survival rate of only 3%. Spiral CT is main imaging diagnostic technique of the patients with pancreatic carcinoma. The value of spiral CT angiograpy(SCTA) in the pre-operative assessment of vascular involvement and resectability of pancreatic carcinoma is exploring at home and abroad. Purpose:To study the value of spiral CT angiograpy in the pre-operative assessment of vascular involvement and resectability of pancreatic carcinoma.Material and Methods:39 cases of pancreatic carcinoma underwent pre-operative SCTA. Reconstruction of peripancreatic vessels was performed with multiplanar volume reformation (MPVR) and maximum intensity projection(MIP). Vascular involvement of pancreatic carcinoma evaluated by three radiologists was validated at operation for comparison. Correlation was made between SCTA findings and operative results. Results:8 out of 10 pancreatic carcinomas which were considered to be resectable by SCTA were resected by operation with a positive predictive value of 80%. Only 2 case was resected by operation in 29 unresectable cases predicted by SCTA with a positive predictive value of 93.1% . Conclusion:SCTA can define the vascular involvement of pancreatic carcinoma with high accuracy. Pre-operative SCTA is necessary to avoid unexpected exploring operation.