Chulalongkorn Medical Journal


Background : The incidence of pancreatic cancer has been increasing.CT scan is effective and standard modality for imaging ofpancreatic cancer.Objective : To describe CT findings in pancreatic ductal adenocarcinomaat King Chulalongkorn Memorial Hospital and to subgroupanalyze the enhancement patterns and presence of metastasisof each histological grading.Setting : Department of Radiology and Department of Pathology, Facultyof Medicine, Chulalongkorn UniversityDesign : Retrospective descriptive studyMaterials and Methods : Preoperative dual phase abdominal CT scans and pathologicalreports of 40 patients with pancreatic adenocarcinoma in KingChulalongkorn Memorial Hospital from 2003 to 2008 wereretrospectively reviewed.Results : In 40 patients, 13 were male and 27 were female with their meanage of 61.9 ± 2.36 years old. Most common location waspancreatic head in 29 patients. The tumor size ranged from1.4-10.9 cm with the mean of 3.9 cm. On the precontrast study,28 tumors were isodense and 12 tumors were hypodense. Onarterial phase, all were hypodense. On portovenous phase,36 tumors were hypodense and 4 tumors were isodense.Pancreatic duct dilatation was seen in12 patients (30%) andbile duct dilatation was seen in13patients (32.5%). Arterialinvolvement was seen in 22 patients (55%); the splenic arterywas the most commonly involved. Venous involvement was seenin 27 patients (67.5%); the splenic vein and SMV were the mostcommonly involved. Adjacent organ invasion was seen in17 patients (42.5%); the duodenum was the most commonlyinvolved. Regional node involvement was seen in 12 patients(30%); the aortocaval node was the most commonly involved.Metastasis was seen in 15 patients (37.5%); liver metastasis wasthe most common. There was no statistically significant correlationof enhancement pattern and the presence of metastasis withtumor grading.Conclusion : The most common CT findings of pancreatic ductaladenocarcinoma was ill-defined mass with hypodensity on arterialphase. The most common location was pancreatic head. Therewas no statistically significant correlation of enhancement patternand the presence of metastasis with tumor grading.


Faculty of Medicine, Chulalongkorn University

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