Efficacy of perfusion CT in differentiating of pancreatic ductal adenocarcinoma from mass-forming chronic pancreatitis and characterization of isoattenuating pancreatic lesions.
Abdom Radiol (NY)
; 44(2): 593-603, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30225610
ABSTRACT
PURPOSE:
Multidetector computed tomography (MDCT) is routinely used in the diagnosis of pancreatic ductal adenocarcinoma (PDAC), but it may be inadequate in some cases, especially mass-forming chronic pancreatitis (MFCP) and isoattenuating pancreatic lesions. Perfusion CT (pCT) may help resolve this problem. The aim of this study was to evaluate whether pCT could help differentiating PDAC from MFCP and in characterization of isoattenuating pancreatic lesions. MATERIALS ANDMETHODS:
This prospective study included 89 cases of pancreatic lesions detected by MDCT and further analyzed with pCT. Sixty-one cases with final pathological diagnosis PDAC and 12 cases with MFCP were included from the study. Blood volume (BV), blood flow (BF), mean transit time (MTT), and permeability surface area product (PS) maps were obtained. Perfusion values obtained from the lesions and normal parenchyma were compared.RESULTS:
Compared with normal parenchyma, BV, BF, PS were lower and MTT was longer in PDAC and MFCP (p < 0.05). Compared with MFCP, BV, BF, PS were lower and MTT was longer in PDAC (p < 0.001). Compared with normal parenchyma, BV, BF, PS were lower and MTT was longer in isoattenuating lesions, (p < 0.001). Cutoff values of 7.60 mL/100 mL, 64.43 mL/100 mL/min, 28.08 mL/100 mL/min for BV, BF, PS, respectively, provided 100% sensitivity and specificity and 7.47 s for MTT provided 98.3% sensitivity, 80% specificity for distinguishing PDAC from MFCP.CONCLUSION:
pCT is a useful technology that can be helpful in overcoming the limitations of routine MDCT in diagnosing PDAC and characterization of isoattenuating lesions.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
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Adenocarcinoma
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Carcinoma Ductal Pancreático
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Pancreatite Crônica
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Tomografia Computadorizada Multidetectores
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article