Usefulness of the Rotating Pancreatography as a Three-Dimensional Imaging Diagnosis

Hiroshi Ishii, Mitsuo Kusano, Mitsunori Hoshino, Akio Nakamura, Yasushi Koike, Masaki Ohori, Tetsuji Enosawa, Sho Oyama, Atsushi Ota and Reiko Koike

Department of Surgery, Division of General & Gastroenterological Surgery, Showa University, School of Medicine

We analyzed the pancreatic ductal system using rotating 3-dimensional endoscopic retrograde pancreatography. Subjects were 32 patients with pancreatic diseases; 8 with invasive ductal carcinoma of the pancreas, 5 with pancreatic cysts, and 4 each with intraductal pancreatic neoplasm, anomalous arrangement of the pancreaticobiliary ductal system, and pancreatic malfusion, and 7 with others. Contrast medium was injected endoscopically through the papilla of Vater and rotating pancreatography conducted as follows: horizontal spin was done in rotating radiographic imaging 180 degrees to patient on the horizontal axis, cranial spin and caudal spin in tilting imaging to the cranial and caudal position at 30 degrees to the horizontal axis, in craniocaudal spin imaging 60 degrees from the cranial to caudal position, and with additional compression study. Pancreatic ductal systems were clearly recognized by each spinning image and rotating pancreatograms enabled better space analysis than conventional endoscopic pancreatograms. This procedure is thus useful in grasping the status of the pancreatic ductal system in patients with anomalous arrangement of the pancreaticobiliary ductal system and pancreatic malfusion. This procedure was valuable in clarifying pancreatic ductal system status and should prove useful in examination of patients with pancreatic disease.

Key words
endoscopic retrograde pancreatography, rotating pancreatography, 3-dimensional pancreatography, pancreatic ductal system, pancreatic disease

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Hiroshi Ishii Department of Surgery, Division of General & Gastroenterological Surgery, Showa University, School of Medicine 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 JAPAN

Accepted
February 28, 2001

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