Helical CT of the pancreas: a comparison of cine display and film-based viewing.

ABSTRACT

OBJECTIVE: Radiologists must manage a tremendous number of helical CT images daily. Hence, the use of cine display review is increasing. Our aim was to compare cine display of helical CT examinations of the pancreas with conventional film-based viewing. SUBJECTS AND METHODS: Forty-eight consecutive patients undergoing helical CT of the pancreas were prospectively included in the study. Five-millimeter-thick contrast-enhanced helical CT sections of the pancreas were reconstructed in 1-mm increments for cine display review and in 5-mm-thick increments for film-based review. Two radiologists reviewed the two sets of data independently. Review of the cine display images was followed by review of the film-based images 2 months later. For both the cine display and the film-based images, reviewers used a four-point scale to grade vascular anatomy (splenic vein and artery, superior mesenteric vein and artery, portal confluence, dorsal pancreatic artery, and gastroduodenal artery); ductal anatomy (common bile duct in its hilar, suprapancreatic, and intrapancreatic portions and pancreatic duct in its caudal, corporeal, and cephalic portions); sharpness of the pancreatic and lesion contours; and overall image quality. RESULTS: The conspicuity of pancreatic contours was graded better on cine display (p = .0035). All venous and arterial landmarks were graded significantly better on cine display. Likewise, visibility of the common bile ducts and pancreatic ducts was scored significantly better with cine display. In three patients, cine display images revealed the pancreatic duct, and the film-based images did not. Although 21 lesions were shown on both sets of images, the lesions were better seen on cine display (p < .005). CONCLUSION: Vascular and ductal anatomy is better delineated on cine images generated from overlapped sections than on conventional film-based images. Lesions are also more sharply delineated on cine display images.