[Assessment of unresectability of pancreatic carcinoma by enhanced-CT and selective angiography].
OBJECTIVE
One of the major limitations of curative resection in the patients with pancreatic cancer is local tumor extension to the major vessels surrounding pancreas. Therefore the assessment of the involvement of major arteries surrounding pancreas by tumor before operation is very important for the judgement of respectability of pancreatic carcinoma. This study was designed to assess the clinical value of contrast-enhanced CT(CECT) and selective angiography (SAG) in predicting the unresectability of patients with pancreatic cancer.


METHODS
From Aug 7, 1996 to Aug 12, 2000, 67 patients with pancreatic ductal adenocarcinoma proved pathologically were retrospectively analyzed. Of these patients, 31 and 54 patients were treated with CECT and SAG, respectively. The involvement of major vessels surrounding pancreas in CECT and SAG were assessed by operator according to specific criterias, which were compared with finding in operation. Finally, the accuracy of the method was assessed.


RESULTS
Among 31 cases who were treated with CECT, 13 were judged unresectable by CECT; and 12 were found unresectable during operation, with predict value of 91%. Among 54 cases who were treated with SAG, 28 were judged unresectable by SAG; and 23 were found unresectable during operation, with predict value of 82%. The sensitivity, specificity, and predict value of CECT and SAG were 60%, 91%, 92%, and 77%, 79%, 82%, respectively. The sensitivity, specificity, and predict value of CECT combined with SAG were 91%, 100%, 100%, respectively.


CONCLUSIONS
Enhanced CT and SAG are useful in assessing the unresectability of pancreatic carcinoma, the combination of two ways can improve the sensitivity, specificity and predict value.
Zhang
Li-yang
LY
Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, P. R. China. liyangzhang25@hotmail.com
Zhao
Yu-pei
YP
D000792:Angiography; D006801:Humans; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed