Bluemke D A, Cameron J L, Hruban R H, Pitt H A, Siegelman S S, Soyer P, Fishman E K
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
Radiology. 1995 Nov;197(2):381-5. doi: 10.1148/radiology.197.2.7480681.
To evaluate the accuracy of spiral computed tomography (CT) in assessing the resectability of small pancreatic ductal adenocarcinoma and to correlate the CT findings with histopathologic and surgical findings.
Spiral CT scans obtained in 64 patients who underwent surgery for potentially resectable pancreatic adenocarcinoma were prospectively assessed for tumor resectability. CT findings were correlated with surgically assessed extent of tumor and pathologic findings.
Fifty-seven (89%) of 64 carcinomas were detected with spiral CT. Twenty-four carcinomas were resectable at surgery and 40 were not. The average size of resectable tumors was 3.1 cm (range, 1.0-7.5 cm). The overall accuracy of spiral CT for assessing resectability was 70%. Of resected tumors, 14 were hypoattenuating compared with the remaining pancreas and 10 were isoattenuating. Eleven tumors showed neointimal proliferation in arterioles at histologic examination.
Further progress in preoperative staging of pancreatic ductal adenocarcinoma with spiral CT should be directed toward improving detection of small pancreatic tumors and assessment of early metastatic disease.
评估螺旋计算机断层扫描（CT）在评估小胰腺癌可切除性方面的准确性，并将CT表现与组织病理学及手术结果相关联。
前瞻性评估64例因潜在可切除性胰腺腺癌接受手术的患者的螺旋CT扫描结果，以判断肿瘤的可切除性。将CT表现与手术评估的肿瘤范围及病理结果相关联。
64例癌灶中57例（89%）通过螺旋CT检测到。24例癌灶手术时可切除，40例不可切除。可切除肿瘤的平均大小为3.1厘米（范围1.0 - 7.5厘米）。螺旋CT评估可切除性的总体准确率为70%。在切除的肿瘤中，14例相对于其余胰腺呈低密度，10例呈等密度。组织学检查显示11例肿瘤的小动脉有新生内膜增生。
螺旋CT在胰腺癌术前分期方面的进一步进展应致力于提高小胰腺肿瘤的检测及早期转移疾病的评估。
