Spiral multi-phase CT in evaluating resectability of pancreatic carcinoma.

OBJECTIVES

To evaluate the specific manifestations of pancreatic carcinoma on spiral multi-phase CT and its resectability before operation.

METHODS

Ninety-seven patients were confirmed operatively and pathologically. Enhanced CT scan was performed with intravenous injection bolus of approximately 75-120 ml (1-1.5 ml/kg body weight) contrast medium at a rate of 2.5-3 ml/s. In 68 patients receiving dual-phase scan, the delayed scan time of arterial and venous phases was 18-20 s and 60-70 s, respectively, and in 29 patients receiving three-phase scan, the delayed scan time of arterial, pancreatic and portal venous phases was 18 s, 40 s and 75 s, respectively, with a slice of 3-5 mm thickness, a pitch of 1-1.5, and a reconstruction interval of 2.5-4.8 mm.

RESULTS

Positive and negative predictive values of unresectable tumors were 97.65% and 75.86%, respectively. The sensitivity and accuracy were 90.67% and 90.72%, respectively. Positive predictive values of dual-phase and three-phase were 95.83% and 100%, respectively; negative predictive values were 75% and 77.78%, respectively.

CONCLUSIONS

Spiral multi-phase CT is superior in revealing the involvement of peripancreatic vessels, the invasion of the neighboring organs, the size, shape and range of carcinoma, and the metastasis of liver and lymph node. The predictability of resection is obviously increased for patients with pancreatic carcinoma.