Triantopoulou Charikleia, Papaparaskeva Kleo, Agalianos Christos, Dervenis Christos
Radiology Department, Konstantopouleio General Hospital, Athens, Greece.
Histopathology Department, Konstantopouleio General Hospital, Athens, Greece.
Eur J Radiol Open. 2016 Mar 11;3:49-59. doi: 10.1016/j.ejro.2016.02.001. eCollection 2016.
The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts). The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3-4 mm). This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure-consistency (areas of necrosis-hemorrhage-fibrosis-inflammation), the degree of vessels' infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors' consistency and way of extension helps to improve radiologists' diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.
本研究的目的是评估一种新型手术标本解剖技术在不同类型胰腺肿瘤病例中的可行性，并提供放射学与病理学的相关性。在我们医院，这是一家胰腺疾病转诊中心，胰腺切除标本的宏观评估由病理学家采用轴向切片技术进行（而非传统的纵向切开主胰管和/或胆总管并沿两管确定的平面切片的方法）。标本在垂直于降部十二指肠纵轴的轴向平面上切片。该操作会产生大量薄片（3 - 4毫米）。这个平面与CT或MRI的平面相同，病理学与影像学之间的相关性一目了然。我们研究了70例疑似不同实性和囊性胰腺肿瘤的病例，并对肿瘤大小和位置、结构一致性（坏死、出血、纤维化、炎症区域）、血管浸润程度、胰管和胆总管大小以及距切缘的距离进行了相关性分析。记录影像学漏诊的发现或陷阱，并试图解释放射学评估与组织病理学发现之间的所有差异。放射学与病理学的相关性极其重要，它能提供关于影像学局限性的关键信息，并有助于对外科手术标本进行质量评估。深入了解不同胰腺肿瘤的质地和扩展方式有助于提高放射科医生的诊断准确性，最大限度减少放射学与手术的不匹配，避免患者接受不必要的手术。
