Tr Prajwal, Prasad Umakant, Kumar Deepak, Sinha Neetu, Bharti Rashmi R, Singh Rakesh Kumar, Kumari Ankita
Radiodiagnosis, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Pathology, Indira Gandhi Institute of Medical Sciences, Patna, IND.
Cureus. 2025 May 6;17(5):e83606. doi: 10.7759/cureus.83606. eCollection 2025 May.
Pancreatic neoplasms are associated with high morbidity and mortality, largely due to late diagnosis and challenges in accurate staging. Multiphasic computed tomography (CT) is a critical imaging tool for evaluating pancreatic masses offering detailed information on lesion characterization and surgical resectability. Precise radiological assessment is vital for treatment planning, and correlating imaging findings with histopathology improves diagnostic efficiency.
This prospective study was conducted on 50 patients with clinically suspected pancreatic neoplasms who underwent multiphasic CT imaging. Non-contrast, late arterial (pancreatic phase), and portal venous phase images were acquired following standardized contrast-enhanced CT protocols. Lesions were evaluated for size, morphology, enhancement patterns, vascular involvement, and local invasion. Resectability was assessed according to the Dutch Pancreatic Cancer Group (DPCG) criteria. Imaging findings were correlated with the final histopathological diagnosis to determine diagnostic sensitivity and specificity.
In the vast majority of cases, 43 out of 50 (86%) were diagnosed as adenocarcinoma. Other diagnoses, such as mucinous cystadenoma, solid pseudo-papillary epithelial neoplasm (SPEN), and neuroendocrine tumor, were very uncommon, each making up 4% of the total cases. Multiphasic CT showed excellent sensitivity and specificity of 100% and 85.7%, respectively, in diagnosing pancreatic neoplasms. Out of 50 cases, 16 cases were found to be resectable, 10 cases were borderline resectable, and 24 cases were non-resectable, out of which 15 cases showed distant metastasis.
Multiphasic CT is a highly accurate, non-invasive modality for the evaluation and characterization of pancreatic masses. It demonstrates a strong correlation with histopathological findings, reliably assesses vascular involvement, and predicts resectability according to DPCG criteria. Therefore, early and accurate CT-based evaluation is critical for optimal treatment planning and improving patient outcomes.
胰腺肿瘤与高发病率和死亡率相关，这主要归因于诊断延迟以及准确分期方面的挑战。多期计算机断层扫描（CT）是评估胰腺肿块的关键成像工具，可提供有关病变特征和手术可切除性的详细信息。精确的放射学评估对于治疗计划至关重要，并且将影像学表现与组织病理学结果相关联可提高诊断效率。
本前瞻性研究对50例临床怀疑患有胰腺肿瘤的患者进行了多期CT成像检查。按照标准化的对比增强CT方案获取非增强、动脉晚期（胰腺期）和门静脉期图像。对病变的大小、形态、强化方式、血管受累情况及局部侵犯情况进行评估。根据荷兰胰腺癌研究组（DPCG）标准评估可切除性。将影像学表现与最终的组织病理学诊断结果相关联，以确定诊断的敏感性和特异性。
在绝大多数病例中，50例中有43例（86%）被诊断为腺癌。其他诊断，如黏液性囊腺瘤、实性假乳头状上皮性肿瘤（SPEN）和神经内分泌肿瘤，非常少见，各占总病例数的4%。多期CT在诊断胰腺肿瘤方面显示出极佳的敏感性和特异性，分别为100%和85.7%。50例病例中，16例被发现可切除，10例为临界可切除，24例不可切除，其中15例显示远处转移。
多期CT是评估和表征胰腺肿块的一种高度准确的非侵入性方法。它与组织病理学结果显示出很强的相关性，能够可靠地评估血管受累情况，并根据DPCG标准预测可切除性。因此，早期且准确的基于CT的评估对于优化治疗计划和改善患者预后至关重要。
