Chew Cindy, O'Dwyer Patrick J
Department of Radiology, Hairmyres Hospital, Glasgow, United Kingdom.
Department of Surgery, Glasgow University, Glasgow, United Kingdom.
Singapore Med J. 2016 Jun;57(6):334-8. doi: 10.11622/smedj.2016109.
Accurate staging of patients with pancreatic cancer is important to avoid unnecessary operations. The aim of this study was to prospectively assess the impact of magnetic resonance (MR) imaging on preoperative staging of liver in patients with findings of resectable pancreatic cancer on computed tomography (CT).
All patients who presented to a tertiary referral centre with pancreatic cancer between April 2012 and December 2013 were included in the study. Patients with findings of resectable disease on CT underwent further liver diffusion-weighted MR imaging, using a hepatocyte-specific contrast agent.
A total of 583 patients with pancreatic cancer were referred. 69 (11.8%) had resectable disease on CT. Of these 69 patients, 16 (23.2%) had liver metastases on MR imaging, while 6 (8.7%) had indeterminate lesions. Of the 16 patients with positive MR imaging findings of liver metastases, 11 died of pancreatic cancer, with a mean survival time of nine months (95% confidence interval [CI] 5.22-14.05). The mean survival time of the 47 patients with negative MR imaging findings was 16 months (95% CI 14.33-18.10; p = 0.001). Subsequently, 22 of these patients underwent surgery, and only 1 (4.5%) patient was found to have liver metastasis at surgery.
The results of the present study indicate that MR imaging improves the staging of disease in patients with resectable pancreatic cancer.
准确对胰腺癌患者进行分期对于避免不必要的手术至关重要。本研究的目的是前瞻性评估磁共振（MR）成像对计算机断层扫描（CT）显示可切除胰腺癌的患者肝脏术前分期的影响。
纳入2012年4月至2013年12月期间在一家三级转诊中心就诊的所有胰腺癌患者。CT显示可切除疾病的患者使用肝细胞特异性造影剂进一步接受肝脏扩散加权MR成像检查。
共转诊了583例胰腺癌患者。69例（11.8%）CT显示为可切除疾病。在这69例患者中，16例（23.2%）MR成像显示有肝转移，而6例（8.7%）有不确定病变。在16例MR成像显示肝转移阳性的患者中，11例死于胰腺癌，平均生存时间为9个月（95%置信区间[CI]5.22 - 14.05）。47例MR成像显示阴性的患者平均生存时间为16个月（95%CI 14.33 - 18.10；p = 0.001）。随后，这些患者中有22例接受了手术，术中仅1例（4.5%）被发现有肝转移。
本研究结果表明，MR成像可改善可切除胰腺癌患者的疾病分期。
