ObjectiveTo explore the value of multi-slice CT angiography (MSCTA) in peripancreatic vascular invasion of pancreatic carcinoma. MethodsThirty-eight patients with pancreatic carcinoma were detected by MSCTA technology before operation. The peripancreatic vascular invasion of pancreatic carcinoma was evaluated by multi-planar reconstruction (MPR) and maximum intensity projection (MIP) combined with axial image, and compared with the surgical results. ResultsThe MSCTA results showed that there were 12 patients (31.6%) with vascular invasion in 38 patients with pancreatic carcinoma, and the surgical results showed that there were 16 patients (42.1%) with vascular invasion. There was a b fit goodness of two results (kappa=0.665, P=0.000). The sensibility and specificity of MSCTA was 68.8% (11/16) and 95.5% (21/22), respectively. ConclusionsMSCTA technology has a high correct rate in evaluation of peripancreatic vessel encroached by pancreatic carcinoma, the MSCTA result has a b consistency to the surgical result. It has a value of clinical application in evaluation of peripancreatic vessel encroached by pancreatic carcinoma.
【Abstract】Objective To evaluate the prognostic value of plasma D-dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D-dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. MethodsThe plasma D-dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D-dimer level in different Child-pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with χ2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.ResultsIn ChildPugh’s A, B and C patients, the difference of plasma D-dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant (P＜0.05). The differences of plasma D-dimer level between patients with microvascular invasion and patients without vascular invasion were significant (P＜0.01) in Child-Pugh’s B and C patients but was insignificant in Child-Pugh’s A patients (Pgt;0.05). The differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant (P＜0.05), but the differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅲ tumor and patients with TNM Ⅳ tumor were insignificant (Pgt;0.05).ConclusionPlasma D-dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child-pugh’s classification.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.