[Imaging diagnosis of carcinoma of the ampulla of Vater].
Ten patients with carcinoma of the ampulla of Vater were reviewed with both ultrasonography (US), CT scans (n = 10), and hypotonic double contrast duodenum examination (n = 5). Tumor was shown by US as abrupt obstruction of distal common bile duct (n = 6), a small mass well-delineated within the dilated distal common bile duct (CBD) (n = 4). The second part of duodenum was depicted clearly in CT scan without enhancement, and a small filling defect could be revealed at the inner surface in 5 cases, as well as an abrupt obstruction of distal CBD, local mass was shown in 4 cases. Enhancement of tumor manifested as local mass and/or ductal wall thickening after iv contrast administration was shown in 3 cases. One case with local lymph node enlargement (25 mm) was revealed by US as well as CT. Non-resectability is implicated by the ill-defined contour of tumor mass and/or portal vein, superior mesenteric artery and vein, but resectability cannot be excluded by displacement and distortion of these vessels with clear delineation. Detectability of lymph node smaller than 10 mm and evaluation of T, N staging are limited by imaging examination. Local filling defect and irregularity of mucous membrane of duodenum were revealed in 4 cases by hypotonic double contrast examination.
Shi
M
M
Department of Diagnostic Radiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing.
Luo
D
D
Zhou
C
C
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000000981:diagnostic imaging*; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography