Imaging diagnosis of pancreatic cancer

By | April 11, 2012

1.B ultrasound: B-mode ultrasound examination painless non-invasive, can directly display the pancreas and peripancreatic images, simple, repeated checking, and low cost, is generally recommended as the method of election. However, there is B-positive findings of pancreatic cancer diagnosis does not mean that. In addition to false positive and false negative, B-the actual detection rate of about 70%. In addition B-positive also provide clues for further diagnosis.
B-positive diagnosis of pancreatic cancer was 63% -93%, the main and common ultrasound imaging is:
the limitations of the pancreas increases, irregular contour, due to the uneven strength of the sound.
nodular echo the dark zone.
pancreatic duct obstruction caused by the liquid dark area.
intrahepatic bile duct dilatation, enlargement of the gallbladder, common bile duct thickening.
dilated pancreatic duct. Some patients with pancreatic cancer, although the lesion has involved the common bile duct, but has not yet appeared obstructive yellow plague, but already showing on the B-expansion of the common bile duct, if by "around vessel invasion," the characteristics, application B Yellow Fever over that before the enlargement of the gallbladder clinical, bile duct dilatation, it is possible the early detection of tumors.
2. Endoscopic ultrasonography (EUS) for pancreatic trypsin for the post-abdominal organs, in order to avoid interference with the gas can be directly endoscopic ultrasonic probe to check the descending part of duodenum, head of the pancreas, or stomach, pancreatic body and tail physical examination be obtained more clearly than the surface of the pancreas ultrasound images, thereby improving the detection rate of pancreatic cancer.
3. Duct ultrasound (USP) recently made about the tiny 2mm probe via endoscopy to the papilla, into the pancreatic duct, ultrasound, further improving the diagnostic yield. But the operation is difficult.
4.CT or magnetic resonance imaging (MRI) examination CT and MRI of pancreatic cancer in the diagnostic accuracy rate of 75% -85%, there are reports of up to 80% -100%, which is obviously the case of the disease sooner or later, check on . CT images in the pancreas, the diagnosis of pancreatic cancer is mainly based on partial pancreas increases, deformation, we can see the deformation and increased diffuse pancreas. Dilated pancreatic duct can be seen. As for the image itself, pancreatic cancer, pancreatic cancer depends on the CT and the surrounding pancreatic tissue density differences may be.
When such differences were less obvious, the sound can clearly see the tumor image. If the pancreatic tissue necrosis, or liquefaction, showing a low density area. In addition to using direct sign of pancreatic cancer itself, but can still use the indirect signs of change caused by biliary tract. In the pancreatic cancer cases can be seen in the liver, extrahepatic, including the pancreatic tissue with round or oval low-density expansion of the bile duct to form the image, up to 10mm in diameter or more, known as the "ring shadow" sign. In addition, the image shows enlarged gallbladder, adjacent tissue invasion and lymph node metastasis or ascites.
5. Endoscopic retrograde cholangiopancreatography (ERCP) ERCP pancreatic cancer has the following changes: irregular stenosis and obstruction, the main pancreatic duct or common bile duct mainly diametrically interruption ends were blunt or tail shaped, cup-shaped, etc.; stenosis showed irregular wall rigid, narrow section of contrast agent is sometimes a remote spot distribution was. ERCP in the diagnosis of the advantages can be observed in the ampulla of whether the tumor under direct vision exists, but also to observe whether the infiltration of pancreatic duodenal lesion area, the pancreatic duct and bile duct. ERCP for the diagnosis of pancreatic cancer is currently the most sensitive method of images, the disadvantage is to have specialized equipment, operating with some difficulties, complications.
6. Others such as selective angiography can be seen in the pancreas and the pancreatic artery of the limitations of narrow, irregular edges. Gastrointestinal X-ray contrast can be seen descending part of duodenum pancreatic cancer such as oppression, but these are rarely used.

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