We retrospectively evaluated the contrast-enhanced MDCT images of 17 patients with pancreatic body and tail carcinoma who underwent surgical operation from January 2005 to August 2010.
<Subjects>
12 men and 5 women (ranging in age from 57 to 85 years,
with a mean age of 71.6 years)
・tumor site: body of pancreas (5 case),
body-tail of pancreas (9 cases),
tail of pancreas (3 cases)
*Carcinomas located in or extended to the pancreatic head were excluded.
・Pathological diagnosis : tubular adenocarcinoma in all cases
・TS (tumor size) : TS2 (14 cases),
TS3 (3 case)
・Staging* : Stage III (all 17 cases),
*UICC classification 6th edition,
2006
・Invasion to the extrapancreatic tissues:
anterior tissues (all 17 cases) / posterior tissues (16 cases)
<Imaging technique>
・CT equipment: 32 MDCT scanners,
Aquillion,
Toshiba,
Tokyo,
Japan
・CT parameters: 120 kVp,
a slice thickness of 1.0mm,
a rotation time of
0.5s,
a pitch of 0.8/0.9
・3 phase dynamic study:
(a) 100mL of nonionic iodinated contrast material,
(370 mg I/mL)
(b) Intravenous injection-rate: 3mL/s using power injector.
(c) 40s (arterial phase),
70s (portal venous phase),
150s (delayed phase)
<Definition>
“Peripancreatic radiating thick-strands” was defined as follows:
- The thick-strand structures radiating from primary lesion and are associated with increased CT attenuation of surrounding adipose tissues (Fig.1,
arrows).
- The maximum size: more than 1.5mm in width and 5mm in length.
<Imaging analysis>
- Presence of “peripancreatic radiating thick-strands” on MDCT
a) Frequency
b) Frequency in each 4 area (anterior / posterior / superior / inferior) around the pancreatic body and tail carcinoma
- “Peripancreatic radiating thick-strands” with pathological correlation
- Clinical significance of “peripancreatic radiating thick-strands”
・Frequency of recurrence
- Comparison to control cases (cases of normal and autoimmune pancreatitis)
All axial and coronal CT images of “peripancreatic radiating thick-strands” were assessed by consensus between two abdominal radiologists using a manual paging method (window level/window width: 30/300).