Differential Diagnosis between Tumor-Forming Pancreatitis and Pancreatic Cancer by Percutaneous Transhepatic Portography and Selective Direct Pancreatic Venography.
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概要
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In 32 patients with tumor-forming pancreatitis and 109 patients with pancreatic cancer, the usefulness of percutaneous transhepatic portography (PTP) and selective pancreatic venography (SPV) for differential diagnosis of the two diseases was evaluated. The PTP images were type I in 53.1%, type II in 21.9%, type III in 12.5%, and type IV in 12.5% of the patients with tumor-forming pancreatitis and type I in 20.2%, type II in 23.9%, type III in 37.6%, and type IV in 18.3% of the patients with pancreatic cancer. Advanced images (type III or type IV) were observed in more than half the patients with pancreatic cancer. Mild images classified as type II were observed slightly more frequently in the patients with pancreatic cancer, but the differential diagnosis of the two diseases was difficult in patients showing type II PTP images. SPV findings were primarily hypervascularization (78.1%) and vasodilation (68.8%) in the patients with tumorforming pancreatitis. Although encasement (smooth encasement) was noted in 31.3%, obstruction was found in only 3.1%. In the patients with pancreatic cancer, obstruction was observed in 85.3%, and encasement (irregular encasement) was noted in 78.9%. However, hypervascularization or vasodilatation was infrequent, and the tumor was characteristically imaged as a hypovascular area. PTP and SPV were considered to be useful for the differential diagnosis of tumor-forming pancreatitis and pancreatic cancer.
- 久留米大学医学部 The Kurume Medical Journal 編集部の論文
著者
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AOYAGI Shigeaki
Department of Cardiovascular Surgery, Kurume University School of Medicine
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Ogata Toshiro
Department Of Pathology Tokai University School Of Medicine Kanagawa Academy Of Science And Technolo
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IMAYAMA HIROYASU
Department of Surgery, Kurume University School of Medicine
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Nagashima Jun
Department Of Surgery Kurume University School Of Medicine
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Kinoshita Hisafumi
Department Of Surgery And Oncology Graduate School Of Medical Sciences Kyushu University
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OGATA TOSHIRO
Department of Surgery, Kurume University School of Medicine
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