Detection of Small Pancreatic Tumors with Multiphasic Helical CT
Yulia Lisenko Bronstein1,
Evelyne M. Loyer2,
Harmeet Kaur2,
Haesun Choi2,
Cynthia David2,
Ronelle A. DuBrow2,
Lyle D. Broemeling3,
Karen R. Cleary4 and
Chusilp Charnsangavej2
1 Department of Radiology, Lady Davis Medical Center, Michal St. 7, Haifa 34362,
Israel.
2 Department of Diagnostic Radiology, The University of Texas M. D. Anderson
Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030.
3 Department of Biostatistics, The University of Texas M. D. Anderson Cancer
Center, Houston, TX 77030.
4 Department of Pathology, The University of Texas M. D. Anderson Cancer Center,
Houston, TX 77030.
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Fig. 1A. —39-year-old man with small hypodense mass that exhibits
typical appearance of pancreatic carcinoma. Contrast-enhanced CT scan shows
small hypodense mass (arrow) deforming contours of inferior portion
of head of pancreas and dilated common bile duct (arrowhead).
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Fig. 1B. —39-year-old man with small hypodense mass that exhibits
typical appearance of pancreatic carcinoma. Contrast-enhanced CT scan obtained
below level of A shows mass (arrow) and abrupt obstruction of
common bile duct (arrowhead).
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Fig. 1C. —39-year-old man with small hypodense mass that exhibits
typical appearance of pancreatic carcinoma. Contrast-enhanced CT scan obtained
below level of B shows small hypodense mass (arrow).
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Fig. 2A. —67-year-old woman with small hypodense mass that exhibits
typical appearance of pancreatic carcinoma. Contrast-enhanced CT scan shows
obstructed pancreatic and common bile duct (arrowhead) with atrophy
of pancreatic body (arrow). Biliary stent is in place.
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Fig. 2B. —67-year-old woman with small hypodense mass that exhibits
typical appearance of pancreatic carcinoma. Contrast-enhanced CT scan obtained
below level of A shows hypodense mass (arrow) in head of
pancreas. Pancreatic parenchyma has lost its normal lobular texture at site of
mass. Biliary stent is seen within mass.
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Fig. 3A. —63-year-old man with false-negative CT findings for
pancreatic carcinoma. Tumor was in head of pancreas and measured 2 cm at
pathologic examination. Contrast-enhanced CT scan shows dilated common bile
duct (arrowhead) with stent in place. Pancreatic duct and pancreatic
parenchyma are normal.
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Fig. 3B. —63-year-old man with false-negative CT findings for
pancreatic carcinoma. Tumor was in head of pancreas and measured 2 cm at
pathologic examination. Contrast-enhanced CT scan obtained below level of
A shows normal pancreatic head. Biliary stent (arrowhead) is
in place in common bile duct.
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Fig. 3C. —63-year-old man with false-negative CT findings for
pancreatic carcinoma. Tumor was in head of pancreas and measured 2 cm at
pathologic examination. Contrast-enhanced CT scan obtained below level of
B shows normal head and ampullary region. Biliary stent is seen in
ampullary region.
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Fig. 4A. —69-year-old man with pancreatic carcinoma. Isodense mass in
head of pancreas can be detected by change in texture. Contrast-enhanced CT
scan shows obstructed pancreatic duct (arrowhead).
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Fig. 4B. —69-year-old man with pancreatic carcinoma. Isodense mass in
head of pancreas can be detected by change in texture. Contrast-enhanced CT
scan obtained below level of A shows isodense mass (arrow) in
head of pancreas. Pancreatic parenchyma has lost its normal lobular texture at
site of mass.
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Fig. 4C. —69-year-old man with pancreatic carcinoma. Isodense mass in
head of pancreas can be detected by change in texture. Contrast-enhanced CT
scan obtained below level of B shows normal-appearing parenchyma in
which lobulation can be defined (arrow). Resolving inflammation is
seen along superior mesenteric artery (arrowheads).
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Fig. 5A. —60-year-old man with pancreatic carcinoma. Pathologically
detected microscopic foci of tumor were interpreted as mass on
contrast-enhanced CT. Contrast-enhanced CT scan shows stent in common bile
duct. Cephalad portion of head (arrow) is small.
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Fig. 5B. —60-year-old man with pancreatic carcinoma. Pathologically
detected microscopic foci of tumor were interpreted as mass on
contrast-enhanced CT. Contrast-enhanced CT scan below level of A shows
small, low-attenuation focus (arrow) seen medial to stent was
interpreted as tumor. Low-attenuation focus is associated with enlargement of
caudal aspect of head.
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Copyright © 2004 by the American Roentgen Ray Society.
