[Combined use of MRI and MR cholangiopancreatography and contrast enhanced dual phase 3-D MR angiography in diagnosis of pancreatic tumors: initial clinical results].
OBJECTIVE
To evaluate the accuracy of a non-invasive "all-in-one" staging MR method in patients with pancreatic tumors.


METHODS
46 patients were prospectively evaluated by a combined MR imaging protocol including breath-hold T1- and T2-weighted pulse sequence, MRCP using a breath-hold 2D-RARE sequence, and breath-hold gadolinium-enhanced dual-phase 3D-MR angiography.


RESULTS
All pancreatic tumors were detected by the combination of cross-sectional imaging and MRCP. In spite of the use of MRCP, definitive differentiation between pancreatic carcinoma and chronic pancreatitis was not possible in 3 (6.5%) out of 46 cases. High quality 3D-MR angiograms were obtained in 43 (93.5%) cases. In 6 (13%) patients 3D-MRA showed an aberrant right hepatic artery. The overall accuracy of MRI in assessing extrapancreatic tumor spread, lymph node metastases, liver metastases, and vascular involvement was 95.7%, 80.4%, 93.5%, and 89.1%, respectively.


CONCLUSIONS
Due to its high accuracy, the "all-in-one" MR protocol may become the most important modality after clinical examination and ultrasound in the diagnostic work-up for most patients with suspicion of pancreatic tumors.
Institut für Klinische Radiologie, Klinikum Mannheim gGmbH, Universitätsklinikum, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg. gaa@ikr.ma.uni-heidelberg.de
J
J
Gaa
K
K
Wendl
I K
IK
Tesdal
H J
HJ
Meier-Willersen
K J
KJ
Lehmann
C
C
Böhm
R
R
Möckel
A
A
Richter
M
M
Trede
M
M
Georgi
D001158:Arteries / Q000473:pathology; D002758:Cholangiography / Q000295:instrumentation*; D002908:Chronic Disease; D003287:Contrast Media; D003937:Diagnosis, Differential; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D008207:Lymphatic Metastasis; D018810:Magnetic Resonance Angiography / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D010179:Pancreas / Q000098:blood supply / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D014680:Veins / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA
Kombinierter Einsatz von MRT, MRCP und kontrastverstärkter 2-Phasen 3D-MRA in der Diagnostik von Pankreastumoren: Erste klinische Ergebnisse.