Morphologic-radiographic correlations of the pancreas.

Numerous noninvasive and invasive imaging modalities are available for the study of pancreatic disease. Disappointingly, the radiographic demonstration of a pancreatic neoplasm is more successful than the treatment of the disease. The proximity of large vascular structures to the pancreas makes its study technically difficult and explains why vascular invasion is readily caused by dispersion of pancreatic secretions (as seen in pancreatitis) or by neoplastic infiltration. The latter heralds nonresectability. Needle biopsy under fluoroscopic or echographic control appears to be gaining popularity as a simple, sensitive and specific method for establishing the diagnosis of pancreatic malignancy. Angiography has its highest yield in the diagnosis of islet cell tumors because they are generally hypervascular. This technique has been complemented by selective catheterization of pancreatic veins followed by hormone bioassay determinations.