[Curved planar reformations in multi-slice spiral CT in pancreatic adenocarcinoma: prediction of invasion of pancreatic and peripancreatic ductal structures].
OBJECTIVE
To investigate the clinical values of the curved planar reformation (CPR) in multi-slice spiral CT (MSCT) in determining the malignant invasion of pancreatic carcinoma into the intrapancreatic and peripancreatic ductal structures.


METHODS
Thirty-seven patients having documented pancreatic carcinoma with tumor involvement of intrapancreatic or peripancreatic ductal structures were enrolled. All patients received dual-phase MSCT scan of upper abdomen. Images generated by CPR technique were used for evaluating the appearances of intrapancreatic and peripancreatic ductal structures.


RESULTS
Malignant invasion of peripancreatic arteries was found in 28 patients and characterized by: obliteration of fat plane between tumor and the artery, with contact surface of more than 180 degrees; stenosis or deformation of the artery; and infarction of the spleen. Invasion of peripancreatic veins was found in 31 patients and characterized by: tumor encasement of the vein, resulting in the narrowing or deformation of the vein; lack of enhancement of the involved venous segment; tumor thrombosis in the venous lumen; and formation of collateral circulation. Invasion of intrapancreatic segment of the common bile duct or pancreatic duct was found in 18 patients and characterized by: sudden interruption of the bile duct or pancreatic duct; narrowing of the bile duct or pancreatic duct; and dilation of the up-stream ducts proximal to the involvement portion. CPR images clearly depicted the direct relationship between tumor mass and the involved ductal structures.


CONCLUSIONS
Invasion of intrapancreatic or peripancreatic ductal structures by pancreatic carcinoma has certain MSCT imaging features. CPR technique is valuable in depicting these imaging findings.
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
Bi
B
Wu
Bin
B
Song
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010183:Pancreatic Ducts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*