Diagnosis of Pancreatic Disease and Decision on Operability by Multiple Slice Dynamic Computed Tomography Scan on Pancreatic Blood Flow

Yozo Aoki, Hiroshi Tanimura, Hiroaki Kawashima, Masakazu Sasaki, Koshin Ueda, Kosuke Shimada, Tomiji Kawaguchi, Yoshihiro Sugimoto, Kazunobu Uesaka, Akito Fuku, Osamu Fukiage

Department of Gastroenterological Surgery, Wakayama Medical College

Multiple slice dynamic computed tomography (CT) scan using the table-sliding rapid sequence scan was performed in 103 patients to assess its usefulness in diagnosing pancreatc lesions and in deciding about operability. In acute and chronic pancreatitis, with deffuse lesions, the characteristic features could be obtained better from the image than from the time-density (T-D) curves. In pancreatic cysts, the existence of the lesion could be identified even on plain CT, and the T-D curves revealed the more conspicuous characteristics of the disease. It is important to distinguish pancreatic cancer from tumor-forming chronic pancreatitis. By the present CT scan using contrast medium, with pancreatic cancer the undamaged area was imaged, but no image was produced by the cancerous area; in tumor-forming chronic pancreatitis, the imaging pattern at an early stage was similar to that in pancreatic cancer, but with the lapse of time, the swelling area was also imaged, thereby making perfect differentiation between two diseases possible. The accurate diagnosis rates of pancreatic cancer by plain CT were 0,75, and 85% in T₁, T₂, and T₃, respectvely, and for the first time 100% in T₄; the rates by the present CT technique were 100% all in cases of pancreatic cancer including T₁ cases.

Key words
multiple slice dynamic computed tomography scan, pancreatic cancer, tumor-forming chronic pancreatitis

Reprint requests
Yozo Aoki Department of Gastroenterological Surgery, Wakayama Medical College
7-27, Wakayama, 640 JAPAN

Accepted
December 13, 1989

To read the PDF file you will need Abobe Reader installed on your computer.