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1.
A Abildgaard F Kolmannskog O Mathisen A Bergan 《Acta radiologica (Stockholm, Sweden : 1987)》1990,31(6):579-584
Eighty-two CT examinations performed on 28 patients who had undergone a modified Whipple procedure including pancreatic duct occlusion were reviewed. Reduction of the antero-posterior diameter of the body and tail of the pancreatic remnant was observed on consecutive scans in 8 patients (29%). Decreasing liver attenuation was seen in 4 patients (14%) postoperatively, and pseudocysts in the pancreatic remnant in 6 (21%). In 10 examinations performed because of suspected intraabdominal abscess postoperatively, abscess was diagnosed in 2 patients. In 62 routine follow-up CT examinations, significant positive findings were diagnosed in 5 patients: tumor recurrence or metastases in 4, and a large pseudocyst in one. CT is of value in the early postoperative phase to reveal postoperative complications and in the follow-up of patients with specific symptoms indicating tumor recurrence or metastases. 相似文献
2.
Jadvar H Fischman A 《Clinical positron imaging : official journal of the Institute for Clinical P.E.T》2000,3(4):156
Purpose: We evaluated the usefulness of FDG-PET in the assessment of patients with suspected pancreatic carcinoma who have previously undergone a Whipple procedure.Methods and Materials: Attenuation-corrected FDG-PET was performed in 11 patients (5 males, 6 females, age range 52-76 years), with suspected recurrent pancreatic carcinoma after Whipple procedure. Recurrence was suspected based on clinical, laboratory (CA19-9 serum tumor marker level), or abdominal CT findings. Diagnostic validation was by histology in 2 patients and radiologic or clinical follow-up (5 to 48 months) in 9 patients. Changes in therapeutic management that were prompted by PET were tabulated.Results: PET was concordant with the findings of abdominal CT in 7 patients (6 true-positive, 1 true-negative). PET detected unsuspected lung lesions in 1 of these patients that was subsequently confirmed by a chest CT. PET was discordant with abdominal CT in 4 patients. PET detected tumor recurrence in 3 of 4 patients in this group (27% of total) who had non-diagnostic CT and elevated CA19-9 serology. Chemotherapy was initiated in 2 of these 3 patients (18% of total), while the other patient died shortly after the PET study from pneumonia and recurrent tumor was confirmed at autopsy. The remaining 1 of 4 patients in the discordant group had a false-positive PET study due to relatively high FDG localization in a displaced loop of bowel.Conclusion: PET is useful in localizing the tumor in post-Whipple patients with suspected recurrent pancreatic carcinoma and can impact their clinical management. 相似文献
3.
Toshinori Hirai Yukunori Korogi Ken Ono Kousei Maruoka Kazunori Harada Satoshi Aridomi Mutsumasa Takahashi 《Cardiovascular and interventional radiology》2001,24(3):176-179
Purpose: To evaluate the utility of an interventional CT system for intraarterial chemotherapy or chemoembolization for locally advanced
and/or recurrent hepatic tumors.
Methods: Thirty-eight patients with locally advanced or recurrent hepatic tumors underwent 73 intraarterial contrast-enhanced CT (IA-CECT)
examinations immediately before chemotherapy or chemoembolization. The degree of tumor vascularity on angiography and enhancement
on IA-CECT was classified into three grades: no, mild, or marked vascularity. The IA-CECT grades were compared with the angiographic
grades.
Results: Twenty-nine (69%) of 42 examinations that were interpreted as having no or mild vascularity on angiography were classified
as marked enhancement on IA-CECT. Based on IA-CECT findings, the position of the catheter was changed in 14 (19%) of 73 CT
examinations. The reasons for the reposition were as follows: weak or no enhancement of the tumor (n = 11) or strong enhancement of the gallbladder wall (n = 3). The treatment strategy was changed in three patients (8%). No major complications relating to the interventional procedures
were observed.
Conclusions: IA-CECT is a reliable method when evaluating the perfusion of the tumor and adjacent normal tissues. The interventional CT
system is useful for performing safe and effective intraarterial chemotherapy or chemoembolization in patients with locally
advanced and/or recurrent hepatic tumors. 相似文献
4.
In-111-leukocyte scintigraphy for detection of infection associated with peritoneal dialysis catheters 总被引:2,自引:0,他引:2
S L Kipper R W Steiner K F Witztum R M Basarab M S Kipper S E Halpern W L Ashburn 《Radiology》1984,151(2):491-494
In 41 patients with clinical evidence of pancreatic islet cell tumors, CT detected 21 of 27 tumors that were proved at surgery (sensitivity 78%) and correctly excluded the diagnosis in 14 of 14 patients with no evidence of tumor at long-term follow-up. Using rapid sequence CT scanning and bolus contrast material infusion, a vascular blush was identified in 13 of 16 tumors (81%). Tumors as small as 0.9 cm were localized. CT identified all malignant tumors, and staging accuracy was 100%. CT is useful as the initial imaging procedure for the diagnosis and staging of suspected islet cell tumors. Pancreatic venous sampling and angiography are complementary to CT for the detection of smaller lesions. 相似文献
5.
Choi YJ Byun JH Kim JY Kim MH Jang SJ Ha HK Lee MG 《European journal of radiology》2008,67(2):321-328
PURPOSE: To evaluate imaging findings of diffuse pancreatic ductal adenocarcinoma. MATERIALS AND METHODS: We included 14 patients (4 men and 10 women; mean age, 64.5 years) with diffuse pancreatic ductal adenocarcinoma on the basis of retrospective radiological review. Two radiologists retrospectively reviewed 14 CT scans in consensus with respect to the following: tumor site, peripheral capsule-like structure, dilatation of intratumoral pancreatic duct, parenchymal atrophy, and ancillary findings. Eight magnetic resonance (MR) examinations with MR cholangiopancreatography (MRCP) and seven endoscopic retrograde cholangiopancreatography (ERCP) were also reviewed, focusing on peripheral capsule-like structure and dilatation of intratumoral pancreatic duct. RESULTS: CT revealed tumor localization to the body and tail in 11 (79%) patients and peripheral capsule-like structure in 13 (93%). The intratumoral pancreatic duct was not visible in 13 (93%). Pancreatic parenchymal atrophy was not present in all 14 patients. Tumor invasion of vessels was observed in all 14 patients and of neighbor organs in 8 (57%). On contrast-enhanced T1-weighted MR images, peripheral capsule-like structure showed higher signal intensity in five patients (71%). In all 11 patients with MRCP and/or ERCP, the intratumoral pancreatic duct was not dilated. CONCLUSION: Diffuse pancreatic ductal adenocarcinoma has characteristic imaging findings, including peripheral capsule-like structure, local invasiveness, and absence of both dilatation of intratumoral pancreatic duct and parenchymal atrophy. 相似文献
6.
Positron emission tomography with 68Ga-EDTA compared with transmission computed tomography in the evaluation of brain infarcts 总被引:2,自引:0,他引:2
K Ericson M Bergstr?m L Eriksson A Hatam T Greitz C E S?derstr?m L Widén 《Acta radiologica: diagnosis》1981,22(4):385-398
The diagnostic value of positron emission tomography (PET) was evaluated in 41 examinations of 40 patients. 68Ga-EDTA was used as a positron source. The findings were correlated with those of conventional of CT scanning. A clearly pathologic accumulation of 68Ga-EDTA was detected in 29 of 41 PET scans. The precontrast CT scans were negative in 11 and non-conclusive in one patient. CT after administration of contrast medium was performed in 29 patients. Of these, 21 had a clearly pathologic PET scan and 14 had visible contrast enhancement on CT examination. The injury of the blood-brain barrier thus was better demonstrated with PET than with CT. The topologic diagnosis was, however, better demonstrated at CT. It seems that CT and PET are supplementary examinations and that PET is superior to CT in the detection of injury of or absence of the blood-brain barrier. 相似文献
7.
MR imaging in the diagnosis of pancreatic disease 总被引:2,自引:0,他引:2
D Tscholakoff H Hricak R Thoeni M L Winkler A R Margulis 《AJR. American journal of roentgenology》1987,148(4):703-709
MR imaging examinations of 20 patients with normal pancreas and of 38 patients with suspected pancreatic disease were analyzed retrospectively to evaluate the ability of MR imaging to depict the normal and abnormal pancreas, establish MR criteria for various pancreatic diseases, determine if MR imaging can distinguish among various pancreatic diseases, and compare the usefulness of MR imaging with CT. In all 20 patients with normal pancreas and in 34 of the 38 patients with suspected pancreatic disease excellent or good evaluation of the pancreas was achieved. A 0.35-T magnet (Diasonics MT/S) was used, and both T1- and T2-weighted images were needed. T1 and T2 relaxation times and MR signal intensities showed no specific pattern to allow consistent differentiation between normal and diseased pancreatic tissue or to distinguish between tumor and inflammation. In the 29 patients in whom MR and CT images could be compared, MR imaging and CT provided equivalent information in 20 (69%). In 4 patients (14%), MR imaging added information, and in 5 patients (17%) of cases, MR imaging yielded less information than CT. MR imaging of the pancreas was found to be superior to CT in selected instances, such as in the staging of pancreatic neoplasms (n = 4) and in the evaluation of pancreatic disease after surgery (n = 3). We conclude that, at present, MR imaging should not be used as the screening method for pancreatic disease but should be reserved as an adjunct when the information provided by CT is insufficient. 相似文献
8.
胰腺囊性病变的CT诊断价值 总被引:10,自引:0,他引:10
目的 探讨CT对胰腺囊性病变的诊断价值。资料与方法 分析54例胰腺囊性病变的CT表现,其中假性囊肿41例,真性囊肿2例,浆液性囊腺瘤3例,黏液性囊腺瘤2例,囊腺癌3例,无功能性胰岛细胞瘤3例。结果 41例假性囊肿CT共检出44个囊性病灶,其中41个病灶为单房囊肿,3个病灶囊内见分隔。40个病灶为低密度,4个病灶为略高密度,增强后均无强化。另见。肾前筋膜增厚(32例)、胰周脂肪层模糊(14例)和胰管扩张(6例)。真性囊肿表现为单发或多发无强化囊性病灶,确诊主要依赖特殊临床资料和组织病理学检查。5例囊腺瘤表现为多房分隔囊性肿块,3例浆液囊腺瘤中2例中央见星芒状钙化,增强后分隔有强化。3例囊腺癌表现为多房分隔囊性病灶,其中2例有肝内多发转移。3例无功能胰岛细胞瘤,2例表现为单房囊性病灶,1例表现为多房分隔及囊内出血。结合病变本身及胰腺和胰周改变(包括肝脏),CT对假性囊肿诊断的准确性为98.1%,对囊性病变诊断的准确性为90.7%。结论 CT能显示病变本身和胰腺及胰周(包括肝脏)形态学改变,有助于胰腺囊性病变的诊断与鉴别诊断。 相似文献
9.
Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. 总被引:24,自引:0,他引:24
D Delbeke D M Rose W C Chapman C W Pinson J K Wright R D Beauchamp Y Shyr S D Leach 《Journal of nuclear medicine》1999,40(11):1784-1791
This study had two purposes: to optimize the semiquantitative interpretation of 18F-fluorodeoxyglucose (FDG) PET scans in the diagnosis of pancreatic carcinoma by analyzing different cutoff levels for the standardized uptake value (SUV), with and without correction for serum glucose level (SUV(gluc)); and to evaluate the usefulness of FDG PET when used in addition to CT for the staging and management of patients with pancreatic cancer. METHODS: Sixty-five patients who presented with suspected pancreatic carcinoma underwent whole-body FDG PET in addition to CT imaging. The PET images were analyzed visually and semiquantitatively using the SUV and SUV(gluc). The final diagnosis was obtained by pathologic (n = 56) or clinical and radiologic follow-up (n = 9). The performance of CT and PET at different cutoff levels of SUV was determined, and the impact of FDG PET in addition to CT on patient management was reviewed retrospectively. RESULTS: Fifty-two patients had proven pancreatic carcinoma, whereas 13 had benign lesions, including chronic pancreatitis (n = 10), benign biliary stricture (n = 1), pancreatic complex cyst (n = 1) and no pancreatic pathology (n = 1). Areas under receiver operating characteristic curves were not significantly different for SUV and SUV(gluc). Using a cutoff level of 3.0 for the SUV, FDG PET had higher sensitivity and specificity than CT in correctly diagnosing pancreatic carcinoma (92% and 85% versus 65% and 61%). There were 2 false-positive PET (chronic pancreatitis, also false-positive with CT) and 4 false-negative PET (all with true-positive CT, abnormal but nondiagnostic) examinations. There were 5 false-positive CT (4 chronic pancreatitis and 1 pancreatic cyst) and 18 false-negative CT (all with true-positive FDG PET scans) examinations. FDG PET clarified indeterminate hepatic lesions or identified additional distant metastases (or both) in 7 patients compared with CT. Overall, FDG PET altered the management of 28 of 65 patients (43%). CONCLUSION: FDG PET is more accurate than CT in the detection of primary tumors and in the clarification and identification of hepatic and distant metastases. The optimal cutoff value of FDG uptake to differentiate benign from malignant pancreatic lesions was 2.0. Correction for serum glucose did not significantly improve the accuracy of FDG PET. Although FDG PET cannot replace CT in defining local tumor extension, the application of FDG PET in addition to CT alters the management in up to 43% of patients with suspected pancreatic cancer. 相似文献
10.
The course of 36 patients with medulloblastoma and ependymoma was evaluated prospectively by clinical examination, radionuclide (RN) studies and computed tomography (CT). Seventeen of the 36 patients (47%) had tumor recurrence. Twelve (41%) of the 29 patients with medulloblastoma had recurrent tumors of which 7 of 12 (58%) were at the primary site and 2 of 12 (17%) were within the ventricles while 10 of 12 (83%) were in the subarachnoid space. Five of the 7 patients with ependymoma had recurrent tumors. In 4 of the 5 patients tumor recurred at the primary site while subarachnoid seeding occurred in 2 of 5 patients (40%) and intraventricular metastases were found in 4 of 5 patients (80%). Progressive ventricular enlargement often accompanied subarachnoid seeding, presumably secondary to obstruction of cerebrospinal fluid (CSF) flow in the subarachnoid pathways. CT and RN scans were frequently complementary in detecting tumor recurrence. 相似文献
11.
Imaging of pancreatic neoplasms: comparison of MR and CT 总被引:2,自引:0,他引:2
E Steiner D D Stark P F Hahn S Saini J F Simeone P R Mueller J Wittenberg J T Ferrucci 《AJR. American journal of roentgenology》1989,152(3):487-491
Thirty-two patients with pathologically proved pancreatic carcinomas or cystadenomas were evaluated with MR images obtained with T1-weighted spin echo (short TR/short TE), inversion recovery, and T2-weighted spin-echo (long TR/long TE) pulse sequences. CT was used as the reference standard to determine the ability of MR to delineate normal and abnormal pancreatic anatomy and thereby to exclude or detect pancreatic malignancy. Short TR/short TE spin-echo sequences were significantly better (p less than .05) than inversion recovery or T2-weighted spin-echo sequences in resolution of both normal and abnormal anatomy. Resolution of pancreatic anatomy correlated (r = .9) with the image signal-to-noise ratio. In seven (22%) of 32 cases, MR visualized pancreatic tumors better than CT did because it showed a signal intensity difference between the tumor and normal pancreatic tissue. Overall, the slight superiority of MR over CT for tumor visualization tended to occur in larger tumors and was not statistically significant. On T1-weighted images, 63% (20 of 32) of pancreatic tumors studied had lower signal intensities than normal pancreatic tissue, whereas on T2-weighted sequences (TE = 60, 120, and 180 msec) only 41% (13 of 32) of tumors had increased signal intensities. Currently available MR imaging techniques offer no significant advantages over CT for evaluating the pancreas for neoplasia. 相似文献
12.
CT of acute pancreatitis: correlation between lack of contrast enhancement and pancreatic necrosis 总被引:12,自引:0,他引:12
This study was performed to determine if a correlation exists between pancreatic parenchymal enhancement or lack thereof on contrast-enhanced CT and surgical evidence of pancreatic necrosis. Accurate CT assessment of pancreatic vascular perfusion would be helpful in preoperative planning before pancreatic debridement and necrosectomy. The CT scans and medical records were blindly and retrospectively reviewed in 13 patients with the operative diagnosis of pancreatic necrosis. In all cases, CT examinations preceded surgery within 72 hr. Surgical and pathologic findings served as the gold standards for the diagnosis of pancreatic necrosis. Seven (54%) of 13 patients had a region or regions of parenchymal necrosis within the head, body, and/or tail of the pancreas seen during surgery. All seven of these patients had no pancreatic enhancement on CT in at least one region of the pancreas (CT sensitivity = 100%). In four of the seven, two regions were found to be necrotic at surgery, but only one of the two segments did not enhance on CT scans. In three of the seven patients, lack of contrast enhancement on CT (no enhancement of the pancreatic head and body in two patients and throughout the gland in another) correlated with necrosis in the same regions at surgery. The remaining six (46%) patients, who had peripancreatic or small, focal, and/or superficial areas of pancreatic necrosis at surgery, had normal pancreatic enhancement on CT. Our results show that regions of pancreatic necrosis found surgically correlate with lack of enhancement of pancreatic parenchyma on CT. Peripancreatic necrosis and minor areas of focal or superficial parenchymal necrosis were not detected on CT. 相似文献
13.
F Fobbe M Dietzel R Korth D Felsenberg S Bender M Hamed C Laass R S?rensen 《AJR. American journal of roentgenology》1988,151(5):1031-1034
A Günther vena caval filter was implanted in the inferior vena cava in 59 patients to prevent pulmonary embolism. This newly available device, which can be inserted percutaneously via a 10-French introduction system, has three filtering planes. No complications occurred at the puncture site. Follow-up included clinical examinations (54 patients), plain radiographs (50 patients), and CT scans (41 patients); these examinations were performed up to 21 months after implantation. Caudal migration of the filter occurred in 35 (70%) of the 50 patients who had radiographs, but no cranial or oblique movement occurred. Occlusion of the filter was noted in three (7%) of 41 patients who had CT examinations. Thromboemboli were seen inside the filter in 16 (39%) of the 41 patients who had CT scans. Recurrent pulmonary embolism was not observed after filter implantation. The Günther vena caval filter seems to be a satisfactory device for preventing pulmonary embolism. 相似文献
14.
J L Pearlberg M A Sandler G B Talpos G H Beute 《Computerized medical imaging and graphics》1989,13(5):411-417
As only a few cases of intrathoracic thyroid malignancy with computed tomographic (CT) examination have been described, we reviewed the CT examinations of three patients with primary and five patients with recurrent thyroid malignancy involving the thorax. Irregular border of the thyroid mass, extension of tumor mass into mediastinal fat or chest wall, or lymphadenopathy suggested the malignant nature of the primary tumor. CT examination in recurrent disease demonstrated mediastinal, hilar and retrocrural adenopathy, compression of major vessels with collateral flow, pulmonary and bony metastases. CT was of value both in identifying the extent of disease and documenting response to treatment. 相似文献
15.
磁共振扩散加权成像在肝癌TACE术后随访中的定性和定量应用 总被引:4,自引:1,他引:3
目的探讨MR扩散加权成像(DWI)在肝癌经导管动脉化疗栓塞术(TACE)后随访中定性和定量评价残留或复发肿瘤组织的能力。方法对16例行TACE术后肝癌患者分别进行DWI、上腹部增强CT和DSA造影检查。DWI检查取扩散敏感梯度因子(b值为0及500s/mm~2),利用固定参数组合的自旋回波-平面回波(SE-EPI)序列。与上腹部增强CT和DSA造影检查相对照,观察碘化油沉积灶、肿瘤坏死组织和肿瘤组织在DWI上的信号特征;分别测量TACE术后病灶的ADC值和对应的CF最大强化值,并作相关性分析。结果DWI显示TACE术后病灶内部信号较复杂,2例(2/16)病灶碘油沉积完整,DSA检查无肿瘤染色,CT图像显示为完整的碘化油沉积灶,DWI为均匀低信号;2例(2/16)病灶为碘油沉积但出现局部缺损,DSA检查可见缺损区肿瘤染色,DWI图像上碘油沉积区表现为低信号,肿瘤染色区为高信号;12例(12/16)病灶DSA检查可见无或稍许碘油沉积,造影见大量肿瘤染色,其内可见无或轻微染色的缺血、坏死肿瘤组织,DWI图像上肿瘤染色区域表现为高信号,缺血坏死区为低或较低信号;对14例(14/ 16)病灶内肿瘤组织的ADC值与其最大CF强化值进行相关性分析,两者存在相关性(r=-0.76490,P<0.01)。结论DWI是一种灵敏的检测肝癌TACE术后肝内新发病灶的无创性成像方法,可监测TACE术后病灶残留或复发活组织和坏死情况,小b值(500s/mm~2)的ADC值可在一定程度上反映肿瘤的血供,可以用于肝癌TACE术后随访。 相似文献
16.
Adenocarcinoma of the pancreatic ducts: comparative evaluation with CT and MR imaging at 1.5 T. 总被引:9,自引:0,他引:9
A prospective comparison of computed tomography (CT) and magnetic resonance (MR) imaging at 1.5 T was performed in 50 patients with the suspected diagnosis of pancreatic carcinoma. CT scans were obtained before and after administration of contrast material in 41 of 50 patients (82%); 34 of 41 postcontrast scans (83%) were obtained with dynamic CT. MR images were interpreted without knowledge of the results of CT, ultrasound, cholangiography, or endoscopic retrograde cholangiopancreatography in 48 patients (96%). Surgical correlation of findings at CT and MR imaging was performed in 24 patients (48%) at laparotomy and in two patients (4%) at autopsy. On T1-weighted MR images, relatively diminished signal intensity of tumor compared with that of the adjacent pancreas was a consistent finding. MR imaging proved superior to CT in identification of pancreatic carcinoma (particularly in smaller intrapancreatic tumors), peripancreatic extension, vascular and portal vein invasion, and duodenal invasion. These results suggest that MR imaging of the pancreas is superior in many instances to CT in preoperative evaluation of pancreatic carcinoma. 相似文献
17.
We report the case of a 52-year-old female with multiple medical complaints and extensive prior clinical and imaging workup who presented to the emergency department with weakness and recurrent episodes of abdominal pain. She had had multiple inconclusive routine computed tomographic (CT) examinations. A 7-mm small bowel tumor was diagnosed on CT enterography and subsequently confirmed to be a carcinoid tumor of the ileum by enteroscopy and at surgery. The diagnosis was suggested prospectively utilizing CT enterography performed in the emergency radiology suite. 相似文献
18.
CT of recurrent retroperitoneal sarcomas 总被引:2,自引:0,他引:2
Gupta AK Cohan RH Francis IR Sondak VK Korobkin M 《AJR. American journal of roentgenology》2000,174(4):1025-1030
OBJECTIVE: We reviewed the medical records and CT scans of 33 patients with recurrent retroperitoneal sarcomas to determine the patterns of recurrent disease. MATERIALS AND METHODS: We reviewed the medical records and CT examinations obtained at the time the recurrence was diagnosed and tabulated data for all patients. Data for patients with high-grade malignancies were compared with those of patients with low-grade malignancies to determine whether there were differences in the interval between initial tumor resection and recurrence. We also compared CT appearances to determine patterns of recurrent disease. RESULTS: Twenty-five of 33 recurrences were detected within 2 years of initial surgery. Only 16 patients had symptoms, and when present, most symptoms were nonspecific. In 28 (85%) patients, recurrent tumor was in the abdomen at the time of diagnosis. In nine patients, the largest detectable abdominal tumor was less than 5 cm in diameter. Interval to recurrence was similar for patients with low- and high-grade tumors. Although the CT appearance was similar for both grades, distant metastases were identified only in patients with high-grade malignancies. CONCLUSION: Primary retroperitoneal malignancies frequently recur within 2 years of initial surgical resection. For asymptomatic patients, diagnosis is typically made during routine follow-up CT. Most patients have abdominal recurrences that may be small when first detected. 相似文献
19.
PURPOSE: To describe the features of pancreatoblastoma at magnetic resonance (MR) imaging, computed tomography (CT), and ultrasonography (US). MATERIALS AND METHODS: Imaging and surgical findings in 10 patients (age range, 2-20 years; mean age, 6.8 years) with pathologically proved pancreatoblastoma were reviewed for tumor size, organ of origin, definition and quality of tumor margins, tumor heterogeneity, calcification, enhancement, ascites, biliary and/or pancreatic ductal dilatation, local invasion, adenopathy, vascular invasion, vascular encasement, metastases, and signal intensity on MR images. Results from 10 CT, seven US, and three MR imaging examinations were reviewed. RESULTS: Five of the 10 tumors were pancreatic; four others appeared to be pancreatic or hepatic. Most had well-defined margins (nine of 10), were heterogeneous (nine of 10), and enhanced (10 of 10). Other findings included calcification (two of 10), biliary and pancreatic ductal dilatation (one of 10), and ascites (three of 10). Hepatic (two patients) and pelvic (two patients) metastases were present. Adenopathy (two patients) and vascular invasion (one patient) were not identified radiologically. Tumors had low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images. CONCLUSION: Pancreatoblastoma is typically a heterogeneous tumor with well-defined margins that may appear to arise from the pancreas or liver. It may behave aggressively, with localized vascular or bowel invasion or with widespread metastatic disease. Although it is rare, it should be considered in the differential diagnosis of an upper abdominal mass in a child. 相似文献
20.
The purpose of this study was to retrospectively assess the diagnostic performance of multi-detector row computed tomography
(MDCT) in an evaluation of pancreas divisum using endoscopic retrograde pancreatography (ERP) as the reference standard. We
analyzed 41 consecutive patients (14 cases of pancreas divisum and 27 cases of standard anatomy) who had undergone both MDCT
and ERP for the evaluation of clinically diagnosed acute pancreatitis between November 2004 and June 2007. The CT reconstruction
thickness and interval were both 3 mm. Two radiologists independently reviewed CT data, and the diagnostic confidence in determining
the pancreatic ductal anatomy was scored using a five-point scale. CT detectability was correlated with the severity of pancreatitis
and the degree of pancreatic necrosis based on the Balthazar index. With consensus, 16 of 41 cases (39.0%) were evaluated
as indeterminate. Ductal anatomy was correctly diagnosed in 23 of 41 cases (56.1%). Eight of 14 cases (57.1%) were correctly
diagnosed as pancreas divisum. Standard anatomy was identified in 15 of 27 cases (55.6%). The inter-observer agreement was
substantial (κ = 0.71). Grade B or more pancreatitis and the presence of pancreatic necrosis significantly influenced the evaluation of
ductal anatomy (p = 0.01 and p < 0.01, respectively). Pancreas divisum was correctly diagnosed in the case of grade A acute pancreatitis. The CT detectability
of pancreas divisum in patients with grade B or more pancreatitis is still relatively low even in the MDCT era. 相似文献