Manak Elena, Merkel Susanne, Klein Peter, Papadopoulos Thomas, Bautz Werner A, Baum Ulrich
Institute for Diagnostic Radiology, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Abdom Imaging. 2009 Jan-Feb;34(1):75-80. doi: 10.1007/s00261-007-9285-2.
The purpose was to assess capabilities of the multidetector-row computed tomography (MDCT) with multiplanar reformations (MPR) for predicting of pancreatic adenocarcinoma resectability. Forty-eight patients deemed to have resectable pancreatic adenocarcinoma after assessment using biphasic MDCT with MPRs underwent surgery for potential tumor resection. Imaging findings were retrospectively evaluated for tumor resectability and correlated with surgical and pathological results. Curative resection was successful in 44 of 48 patients. The positive predictive value for tumor resectability made up 91% with four false-negative results. The reasons for unresectability were venous involvement (1), small liver metastases (2) and peritoneal involvement associated with small metastases to lymph nodes (1). MDCT yielded a negative predictive value of 99% (286 of 288 vessels) for detection of vascular invasion. Our results indicate the tendency towards improved prediction of resectability using MDCT compared to single-detector CT.
目的是评估多排螺旋计算机断层扫描(MDCT)结合多平面重建(MPR)预测胰腺腺癌可切除性的能力。48例在使用具有MPR的双期MDCT评估后被认为可切除的胰腺腺癌患者接受了潜在肿瘤切除手术。对影像学表现进行回顾性评估以确定肿瘤的可切除性,并与手术和病理结果进行关联。48例患者中有44例成功进行了根治性切除。肿瘤可切除性的阳性预测值为91%,有4例假阴性结果。不可切除的原因包括静脉受累(1例)、小的肝转移(2例)以及与小的淋巴结转移相关的腹膜受累(1例)。MDCT对血管侵犯检测的阴性预测值为99%(288条血管中的286条)。我们的结果表明,与单排CT相比,使用MDCT预测可切除性有改善的趋势。