Correlation Research Of Pancreatic Cancer CT Feature And Preoperative Resectability

Cancer of pancreas accounts for 1%~4% of all malignant tumours. Pathogenesy is not identified. here are no evident specificness symptoms. nd it is hard to deal with diagnosis and therapy. Retrospective analysis are performed in 41 cancer of pancreas, with imageology and operation results. provide information for clinical operation and therapy. carcinoma of head of pancreas cases, carcinoma cases body of pancreas cases, and case with obstructive jaundice. tumour size varied from 3 to 10 cm, average is 6.5cm. 3 cases lager than 3 cm, 38 cases larger than 3cm. Direct sign of computerized tomography (CT) is tumour size, density, appearance and circumscription changes. Indirect sign: distension of canal of Wirsung, which is one of most significant sign. And carcinoma of head of pancreas are the main causes. Choledochectasia and tumour at the same deck are the important sign to diagnosis of cancer of pancreas.Ambiguity or disappearance of adipose layer between peripheral organ and pancreas is very important encroachment sign. The other signs including anoma nodus, thickening or stegnosis in hollow viscus abnormal density in close organ. Window leve and width, fat quantity are the main reason that encroachment of fat layer were founded in only 21 cases of all patients. Relation between pancreas tumour and duodenal is key indicatio of resectiom possibility. But only 9 cases founded in all 19 cases, which is lie in that some patients could not drink constrast medium and density close between dodecadactylon and pancreas. Liver is the most common metastatic organ. And liver metastatic tumor is important sign of unresectable cancer of pancreas. Evaluation of resection possibility: CT are important staging means. And resection possibility are lie in peripancreas organ encroachment, lymph follicle metastasis or other organs metastasis. And the involvement of peripancreas blood vessel is main standard. Peripancreas blood vessel are easily offended. The degree of involvement and encroachment are major criterion of resection possibility if without lymphatic metastasis and hepatic metastasis. Metastasis lymph follicle can occurrence solo or mixed together. no obvious density changing after enhancement. and some may show imaging features that similar to primarily focus. Spiral CT, Perfusion Imaging, 3D imaging and combination with other means improve the preoperation accuratissime of CT evaluation. CT staging: Class I carcinoma size less than 3.0cm. No encroachment of close organ and blood vessel. No metastasis. Class II No organ metastasis and lymph follicle. Duodenum encroachment class I. blood vessel encroachment Class I. No metastasis. ClassIII No organ metastasis. With Duodenum encroachment class II, blood vessel encroachment Class II, or lymph follicle FIRST STEP metastasis. CLASS IV No organ metastasis. With Duodenum encroachment class III, blood vessel encroachment Class III, or lymph follicle SECOND STEP metastasis. Class V With Duodenum encroachment class III, blood vessel encroachment Class III, lymph follicle THIRD STEP metastasis, or other organ metastasis. Conclousion: 1. Qualitation and level diagnostic value of CT with cancer of pancreas deserve affirmation. 2. CT Evaluation of encroachment periphery organ deserve affirmation. 3. CT Evaluation of resection possibility deserve affirmation. Class I carcinoma can receive operation Class II carcinoma can receive operation after decohesion of peripancreas blood vessel. Class I carcinoma hardly receive complete resection and with high racurrence rate. CLASS IV could receive palliation therapy. Class V are absolute counterindication of resectiom.