Routine acquisition of images in the arterial phase is unnecessary for detection of pancreatic adenocarcinoma. Images of the pancreas obtained in the hepatic phase with multi-detector row CT most accurately display vascular invasion.

Contrast material-enhanced computed tomographic (CT) scans obtained over a 1 0-year period in 66 patients with metastases to the pancreas were retrospectively reviewed. The primary tumors most commonly responsible for these metastases were renal cell carcinoma (30.3%) and bronchogenic carcinoma (22.7%). Metastases showed no predilection for any particular part of the pancreas. The majority

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A retrospective analysis was performed of contrast material-enhanced current-generation computed tomographic (CT) examinations in 56 patients with documented chronic pancreatitis. Dilatation of the main pancreatic duct was seen in 68% of cases, parenchymal atrophy in 54%, pancreatic calcifications in 50%, fluid collections in 30%, focal pancreatic enlargement in 30%, biliary ductal dilatation in 29%, and alterations in peripancreatic fat or fascia in 16%. The relatively small proportion of examinations in which no abnormalities were observed, 7%, differs from that in early reports, as does the absence of generalized pancreatic enlargement. Pancreatic ductal dilatation and parenchymal atrophy were notably more prevalent than reported previously. Nine of the 17 patients with focal pancreatic enlargement had calculi within the mass, which suggested benign disease; of the eight other patients, two of whom had coexistent carcinoma, this finding was absent and the masses were considered indeterminate at CT.

A retrospective review of 211 computed tomographic (CT)-guided and 58 ultrasound (US)-guided biopsies of pancreatic lesions performed between 1985 and 1989 was undertaken to evaluate the accuracy of diagnosis and the number of complications. Combined CT and US accuracy in the diagnosis of malignancy was 93%. CT-guided biopsies had an accuracy of 86%, and US-guided biopsies had an accuracy of 95%. Accuracy was higher with larger masses (> 3.0 cm, 92%; < or = 3 cm, 81%) and larger needle sizes (16-19 gauge, 92%; 20-22 gauge, 85%) and when the mass was located in the body or tail of the pancreas (93%) rather than the head (84%). Major complications developed in three cases (1.1%). No biopsy-related deaths occurred. Needle passage through the gastrointestinal tract, including the colon, did not cause complications.