DIAGNOSIS AND STAGING OF PANCREATIC ADENOCARCINOMA WITH DYNAMIC COMPUTED-TOMOGRAPHY
DIAGNOSIS AND STAGING OF PANCREATIC ADENOCARCINOMA WITH DYNAMIC COMPUTED-TOMOGRAPHY
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DOI：
10.1016/s0002-9610(05)80443-x
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发表时间：
1993-05-01
影响因子：
3
通讯作者：
RYAN, JA
中科院分区：
文献类型：
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作者：
FREENY, PC;TRAVERSO, LW;RYAN, JA
我们评估了213例胰腺癌患者的动态增强计算机断层扫描（CT）诊断和分期的准确性，并将其与血管造影和手术的准确性进行了比较。213例患者中有207例（97%）做出了正确的胰腺癌CT诊断。肿瘤位于胰头占64%，胰体占22%，胰尾占10%，胰腺弥漫性肿大占4%。根据局部侵犯（72%）、邻近器官侵犯（43%）、血管侵犯（82%）和远处转移（50%），CT将25例（12%）患者分期为可能可切除的肿瘤，188例（88%）患者分期为不可切除的肿瘤。60例患者与血管造影比较，CT漏诊血管侵犯20%，血管造影漏诊血管侵犯5%。在后三种情况下，存在其他不可切除性的CT标准，血管造影没有提供重要的分期信息。71例患者与手术比较，CT准确预测不可切除肿瘤的患者为100%，准确预测可切除肿瘤的患者为72%，其中11例CT可切除肿瘤患者接受了手术切除。中位生存期为22.7个月，4例患者在术后中位生存期为15.5个月。姑息性切除6例，中位生存期为14.4个月。
We assessed the accuracy of dynamic contrast-enhanced computed tomography (CT) in the diagnosis and staging of 213 patients with pancreatic carcinoma and compared it with the accuracy of angiography and surgery. A correct CT diagnosis of pancreatic carcinoma was made in 207 of 213 (97%) patients. Tumors were located in the pancreatic head in 64%, the body in 22%, and the tail in 10%, and enlarged the pancreas diffusely in 4%. CT staged 25 (12%) patients as having potentially resectable tumors and 188 (88%) as having unresectable tumors on the basis of local extension (72%), contiguous organ invasion (43%), vascular invasion (82%), and distant metastases (50%). Compared with angiography in 60 patients, CT detected vascular invasion missed on angiography in 20%, and angiography detected invasion missed by CT in 5%. In there latter cases, other CT criteria of unresectability were present, and angiography provided no significant staging information. Compared with surgery in 71 patients, CT accurately predicted unresectable tumors in 100% of patients and resectable tumors in 72% of patients.Eleven of the patients with CT-resectable tumors underwent resection. Median survival was 22.7 months, with four patients alive at a median of 15.5 months postoperatively. Palliative resections were performed in six patients, and median survival was 14.4 months.