Multimodality Imaging of Neoplastic and Nonneoplastic Solid Lesions of the Pancreas

Low, Gavin; Panu, Anukul; Millo, Noam; Leen, Edward

doi:10.1148/rg.314105731

Cited by 199 publications

(138 citation statements)

References 62 publications

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“…The ability of appropriate identification and location of the lesion, distance from the main pancreatic duct and relationship to adjacent organs and vessels made the procedure safer. Magnetic resonance imaging using equipment with higher magnetic fields and gradient greatly improved the quality and detail of the images (12,22) . Accurate diagnosis can be challenging, and use of a multimodality approach, using magnetic resonance cholangiopancreatography combines the strengths of individual imaging modalities and has a synergistic effect in improving diagnostic yield.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Machado

Surjan

Goldman

et al. 2013

Arq. Gastroenterol.

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-Context -Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives -The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods -All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports.Results -Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions -Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. Pancreaticoduodenectomy. Laparoscopy. development of new instruments more complex laparoscopic procedures were performed such as total pancreatectomy, left pancreatectomy with spleen preservation, resection of uncinate process (15) and pancreatoduodenectomies (16) . The aim of this paper was to review our experience with laparoscopic pancreatic resection over 11-year period. METHODSA retrospective review of a prospectively maintained database was performed. All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were identified. Descriptive data were collected. Preoperative variables included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Pancreatic fistula was Arq Gastroenterol 215

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Machado

Surjan

Goldman

et al. 2013

Arq. Gastroenterol.

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“…Arterial phase imaging is generally performed 30-40 seconds following contrast injection which allows superior visualization of pancreatic masses and peripancreatic arteries. Maximal contrast between hypovascular or cystic masses and the background pancreas provides optimal tumor visualization in this phase [4] . Arterial phase images are routinely displayed at 3 mm intervals.…”

Section: Ct Imaging Techniquesmentioning

confidence: 99%

Imaging of cystic pancreatic lesions

Olpin

Shaaban

2012

JBGC

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Cystic lesions of the pancreas are encountered on abdominal imaging studies on a routine basis. Cystic pancreatic lesions represent a variety of both benign and malignant disease entities that present with a wide spectrum of clinical symptoms. Cystic pancreatic lesions are being detected at an ever increasing rate due to increasingly sophisticated imaging techniques. Various imaging modalities can be employed in the evaluation of cystic pancreatic lesions. While CT serves as the mainstay of routine pancreatic imaging, MR is becoming increasingly utilized in the detection and characterization of suspected cystic pancreatic lesions. Accurate characterization of such lesions is imperative in order to select the most appropriate clinical management.

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“…Cerrahiden yarar görebilecek hastaları doğru seçebilmek için radyolojik görüntüleme yöntemleri tanıda, tedavi yönteminin belirlenmesinde ve tedavi takibinde önemlidir (4) . Manyetik rezonans görüntüleme (MRG) pankreas kanseri teşhisinde güvenilir bir modalite olarak kabul görmüştür (5) . Yapılan çalışmalar, son zamanlarda MRG'deki teknik gelişmelerin (manyetik rezonans kolanjiyopankreatografi (MRKP) ve dinamik MRG gibi) özellikle küçük pankreas tümörlerinin belirlenmesindeki başarısını göstermiştir (3) .…”

Section: Introductionunclassified

Imaging features of pancreatic mass lesions with histopathological correlation: A retrospective analysis

Chousein¹,

Acar²,

Adıbelli³

2017

Terh

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ÖZAmaç: Pankreas kanseri kansere bağlı ölümlerin 4. en sık nedenidir. Pankreas adenokarsinomu (%85-95) ile kistik tümörleri (%10) klinik pratikte sık rastlanılan pankreatik neoplazi grubundandır. Manyetik rezonans görüntüleme (MRG) günümüzde sıklıkla istenilen güvenilir preoperatif hasta değerlendirilmesinde metodudur. Bu çalışmada amacımız, pankreas adenokarsinom (aka) ve kistik tümörlü olguların MRG bulgularını, radyolojik kanı ile patolojik korelasyonu değerlen-dirmek ve ayrıca bu iki tanıyı alan gruplar arasında demografik karşılaştırmayı yapmaktır. Yöntem: Ağustos 2010-Aralık 2015 tarihleri arasında başvuran 45 olgunun preoperatif MRG ve histopatoloji verileri retrospektif olarak elde olunmuştur. Hastalar aka (32 olgu) ve kistik neoplazi (13 olgu) olmak üzere iki gruba ayrılmıştır. Bulgular: Aka olguları kistik neoplaziye kıyasla anlamlı olarak daha ileri yaştaydı (p<0,001). Aka grubundakilerin %54,8'inde düzensiz sınır gözlemlenirken, kistik tümörlerin çoğunda (%69,2) lobüle sınır gözlendi. Histopatolojik sonuç ile kitlesel lezyonun konturu arasında anlamlı ilişki saptandı (p=0,009). Aka grubunda kitlenin T1A sinyali çoğu olguda (%64,3) hipointens izlenirken, kistik tümörlerinde ise olguların tamamı hipointens karakterdeydi. Histopatolojik sonuç ile kitlesel lezyonun T1A sinyal intensitesi arasında anlamlı ilişki saptandı (p=0.038). Histopatolojik bulgular ile cinsiyet, tümörün yeri, boyutu-iç yapısı, pankreatik kanal-safra yolu dilatasyonu, vaskü-ler invazyon, bölgesel lenf nodu ve uzak organ metastazı arasında anlamlı ilişki saptanmadı. Sonuç: Çalışmamızda, MRG ile yapılan incelemelerde, pankreasın adenokarsinom grubu ile pankreasın kistik tümörlerinin yaş ortalamaları, kitlenin sınırı ve kitlenin T1AG sinyal intensitesi arasında istatistiksel anlamlı farklılık saptandı. Ancak, bu iki grupta diğer MRG bulguları ve diğer demografik açılardan anlamlı fark saptanamadı. Histopatolojik tanı ile radyolojik bulgular arasında orta düzeyli ancak anlamlı uyum saptandı (Kappa=0,643, p<0,001).Anahtar kelimeler: Pankreas adenokanseri, pankreas kistik neoplazi, MRG ABSTRACT Objective: Pancreatic cancer is the fourth most common cause of cancer-related deaths. Pancreatic adenocarcinoma (85-95%) and cystic tumors (10%) are frequently encountered group of pancreatic neoplasms in clinical practice. Nowadays, magnetic resonance imaging (MRI) is frequently required reliable method of choice for preoperative evaluation of these patients. In this study, we aimed to evaluate MRI features, MRI-pathologic correlations of pancreatic adenocarcinoma (aca) and cystic tumors, and also to make a demographic comparison between these two diagnostic groups. Methods: Preoperative MRI and histopathology data of 45 patients, admitted between August 2010 and December 2015, were obtained retrospectively. Patients were divided into two groups: aca (32 cases) and cystic neoplasia (13 cases). Results: Aca group of patients were significantly older than those with cystic neoplasia (p<0.001). An irregular tumor border was observed in 54.8% of the ...

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Multimodality Imaging of Neoplastic and Nonneoplastic Solid Lesions of the Pancreas

Cited by 199 publications

References 62 publications

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Imaging of cystic pancreatic lesions

Imaging features of pancreatic mass lesions with histopathological correlation: A retrospective analysis

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