Multiple imaging techniques in the diagnosis of ampullary carcinoma.
BACKGROUND
Ampullary carcinoma is a neoplasia with a good prognosis compared to pancreatic cancer. But it is difficult to early diagnose because it lacks clear clinical symptoms. This study aimed to evaluate the efficacy of abdominal ultrasonography (US), enhanced computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in detecting ampullary carcinoma.


METHODS
Forty-one patients with ampullary carcinoma who had been confirmed pathologically among the inpatients at the First Affiliated Hospital of Zhejiang University School of Medicine from February 2003 to March 2007 were analyzed retrospectively. The accuracy of US, CT, MRCP and ERCP were compared in the diagnosis of ampullary carcinoma.


RESULTS
The accurate rate for detection of ampullary carcinoma with US was 26.83%. The accuracy of CT and ERCP in detection of ampullary tumors was 84.62% and 100%, respectively, which were significantly higher than that of US (P<0.05). The accuracy of MRCP in detection of ampullary tumors was similar to that of US in spite of visualization of obstruction and dilatation of the pancreaticobiliary duct with MRCP.


CONCLUSIONS
Because of the obscure and late onset of symptoms, ampullary carcinoma is difficult to diagnose early. Multiple imaging techniques should be carried out appropriately in order to early diagnose the disease and improve the prognosis.
Chen
Wei-Xing
WX
Department of Gastroenterology, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Xie
Qi-Gui
QG
Zhang
Wei-Fang
WF
Zhang
Xian
X
Hu
Tian-Tian
TT
Xu
Ping
P
Gu
Zhu-Ying
ZY
D000230:Adenocarcinoma / Q000175:diagnosis*; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000592:standards; D003937:Diagnosis, Differential; D003938:Diagnostic Techniques, Digestive System / Q000592:standards*; D042241:Early Diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards; D014463:Ultrasonography / Q000592:standards