Laghi A, Iannaccone R, Catalano C, Carbone I, Sansoni I, Mangiapane F, Passariello R
Department of Radiology, University of Rome La Sapienza, Policlinico Umberto I, Rome, Italy.
Dig Liver Dis. 2002 Oct;34(10):732-8. doi: 10.1016/s1590-8658(02)80025-1.
Computed tomography has become the modality of choice for preoperative evaluation of patients with suspected pancreatic carcinoma, although some limitations are well known.
To evaluate use of multislice spiral computed tomography in preoperative assessment of patients with suspected pancreatic carcinoma using volume-rendering as image reconstruction algorithm.
A total of 27 patients with suspected pancreatic carcinoma underwent multislice spiral computed tomography examination.
All studies were performed on a multislice computed tomography scanner with the following parameters: slice collimation, 1 mm; slice thickness, 1.25 mm; reconstruction interval, 1 mm; scan time, 22-25 sec; mAs, 165. Scans were acquired with a biphasic technique with a 30-sec (pancreatic phase) and a 70-sec (portal venous phase) delay time after start of contrast material injection. Diagnostic confirmation was obtained with surgical exploration, percutaneous biopsy, or with a combination of follow-up imaging studies.
Multislice spiral computed tomography yielded correct diagnosis of pancreatic carcinoma in 20 cases (sensitivity, 95%; specificity, 100%). Positive predictive values for resectability and unresectability were 80% and 93.3%, respectively. Three-dimensional volume-rendered images improved diagnostic confidence in the depiction of major vascular structures. Two cases of anomalous origin of hepatic artery were also identified with volume-rendered images.
Multislice technology improves accuracy of spiral computed tomography for diagnosis and staging of pancreatic carcinoma.
计算机断层扫描已成为疑似胰腺癌患者术前评估的首选方式，尽管其一些局限性是众所周知的。
以容积再现作为图像重建算法，评估多层螺旋计算机断层扫描在疑似胰腺癌患者术前评估中的应用。
共有27例疑似胰腺癌患者接受了多层螺旋计算机断层扫描检查。
所有检查均在多层计算机断层扫描仪上进行，参数如下：层厚准直1毫米；层厚1.25毫米；重建间隔1毫米；扫描时间22 - 25秒；管电流165毫安秒。采用双期扫描技术，在注射对比剂后延迟30秒（胰腺期）和70秒（门静脉期）进行扫描。通过手术探查、经皮活检或后续影像学检查相结合来获得诊断确认。
多层螺旋计算机断层扫描对20例胰腺癌做出了正确诊断（敏感性95%；特异性100%）。可切除性和不可切除性的阳性预测值分别为80%和93.3%。三维容积再现图像提高了对主要血管结构显示的诊断信心。通过容积再现图像还发现了2例肝动脉起源异常的情况。
多层技术提高了螺旋计算机断层扫描对胰腺癌诊断和分期的准确性。
