Weiss H D, Anacker H, Kramann B, Scholze H
Am J Gastroenterol. 1975 Jul;64(1):26-33.
Direct demonstration of intrapancreatic abscesses and pseudocysts can be made by means of duodenoscopic retrograde pancreatography. The most important findings are escape of contrast medium from the duct system into a cavity and its visualization, the tryptic perforation of one or more ducts and the concomitant deformity which may be general or limited to the vicinity of the lesion. The differential diagnosis of pancreatic abscess and carcinoma with penetration of contrast medium in the tumor tissue is supported by the fact that the contours of a necrotic cavity are rather well defined, whereas in carcinoma the extraductal opacification is diffuse. As a rule in a necrotic lesion the ductal system is distorted locally or the whole excretory duct system may be involved. In carcinoma the ductal system generally appears normal distally to the tumor. Accurate demonstration of the necrotic lesion, the assessment as to its localization and size are of decisive importance for indication and choice of the surgical procedure.
通过十二指肠镜逆行胰胆管造影术可直接显示胰腺内脓肿和假性囊肿。最重要的发现是造影剂从导管系统漏入腔内并显影、一个或多个导管的胰蛋白酶性穿孔以及随之而来的可能是全身性的或局限于病变附近的畸形。胰腺脓肿与造影剂渗入肿瘤组织的癌的鉴别诊断依据是，坏死腔的轮廓相当清晰，而癌的导管外造影剂充盈是弥漫性的。通常，在坏死性病变中，导管系统局部扭曲，或整个排泄导管系统可能受累。在癌中，肿瘤远端的导管系统通常看起来正常。准确显示坏死性病变、评估其定位和大小对于手术方式的选择和指征具有决定性意义。
