Vascular involvement in pancreatic neoplasm: a comparison between spiral CT and DSA.
The principal criterion for resectability of pancreatic carcinoma is the assessment of vascular involvement. In a prospective evaluation the ability of Spiral CT Angiography (CTA) to detect vascular involvement in 50 patients with pancreatic carcinoma, was proved; DSA was performed later in all patients. In 20 patients, without vascular involvement, a complete concordance was obtained. Of 30 patients with vascular involvement, there was complete concordance between CTA and angiography in 22 patients and discordance in 8 patients. CTA was superior in 2 cases with periadventitial infiltration and in 5 patients with splenoportal confluence thrombosis. DSA was superior in 1 case with infiltration of the superior mesenteric vein. After surgical evaluation, sensitivity of CTA and DSA was 97% and 77%, respectively, and the negative predictive values were 95% and 74%. As compared to DSA, CTA is more rapid and less invasive and can be considered the modality of choice for preoperative work-up of pancreatic neoplasm.
Squillaci
Ettore
E
Department of Diagnostic Imaging and Interventional Radiology, University of Rome Tor Vergata, Vale Oxford, 81-00133 Rome, Italy.
Fanucci
Ezio
E
Sciuto
Francesco
F
Masala
Salvatore
S
Sodani
Giulio
G
Carlani
Marco
M
Simonetti
Giovanni
G
D000230:Adenocarcinoma / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000175:diagnosis*; D010179:Pancreas / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*