Role of curved planar reformations using multidetector spiral CT in diagnosis of pancreatic and peripancreatic diseases

Abstract

Aim: To investigate the role of curved planar reformations using multidetector spiral CT (MSCT) in diagnosis of pancreatic and peripancreatic diseases.

Methods: From October 2001 to September 2003, 47 consecutive patients with pancreatic or peripancreatic diseases, which were confirmed by operation, endoscopic retrograde cholangiopancreatography and clinical follow-up, were enrolled in this study. CT scanning was performed at a MSCT with four rows of detector. A set of images with an effective thickness of 1.0-2.0 mm and a gap of 0.5-1.0 mm (50% overlap) were acquired in all patients for post-processing. Curved planar reformations were carried out by drawing a curved line on transverse source images, coronal or sagittal multiplanar reformations according to certain anatomic structures (such as cholangiopancreatic ducts or peripancreatic vessels) and the position of lesion.

Results: With thin collimation, MSCT could acquire high-quality curved planar reformations to display the profile of the whole pancreas, to trace the cholangiopancreatic ducts and peripancreatic vessels, and to show the relationship of lesions with pancreas and peripancreatic anatomic structures in one curved plane, which facilitates diagnosis and rapid communication of diagnostic information with referring physicians.

Conclusion: MSCT with thin collimation could be used to create high-quality curved planar reformations in evaluating pancreatic and peripancreatic diseases with pertinent anatomic information and relative pathologic signs to facilitate the diagnosis and enhance communication with the referring physician. Curved planar reformations can serve as supplements for transverse images in diagnosis and management of pancreatic and peripancreatic diseases.

Figure 1

Curve drawn on a transverse image along the pan-creatic duct in a patient with pancreatic adenocarcinoma.

Figure 2

Curve obtained from the curved line on Figure 1 dis-played the hypoattenuation tumor at the head of pancreas and the distal dilated pancreatic duct (arrow).

Figure 3

Neuroendocrine tumor of pancreas. Curved planar reformations during pancreatic parenchyma phase demon-strated the enhanced mass located in the tail of pancreas.

Figure 4

Neuroendocrine tumor of pancreas and peripancreatic pseudocyst. Curved plane showed a non-enhanced hypoattenuation mass located in the pancreatic parenchyma (arrow) and a pseudocyst at the port of spleen during the pan-creatic parenchyma phase. The normal pancreatic duct was also well depicted (long arrow).

Figure 5

Real cyst of pancreas. Curved planar reformations obtained after CT cholangiography showed the dilatation and obstruction of bile duct system, and the beaded-like dilatation of pancreatic duct. The cyst located beside the common bile duct. There was no contrast media entrancing into cyst.

Figure 6

A curved plane tracing superior mesenteric artery of the same patient with Figure 1 and Figure 2 demonstrated the vessel was not involved. The tumor was confirmed to be re-sectable at operation.

Figure 7

A curved plane tracing the celiac trunk and the splenic artery of a patient with pancreatic adenocarcinoma demon-strated the irregular stricture (arrow).

Figure 8

Ampullary carcinoma. Curved planar reformations depicted a low attenuation mass around the pancreatic head and the dilatation of both bile duct (arrow) and pancreatic duct (long arrow).

Figure 9

Gastric cancer with peripancreatic adenopathy. Curved planar reformations depicted the dilatation of the pancreatic duct.

Figure 10

Choledocholithiasis of common bile duct. Curved plane displayed the dilatation of the bile duct system and the pancreatic duct. The location of stones was depicted clearly.

Figure 11

Peripancreatic adenopathy. Curved planar refor-mations showed several enlarged lymph nodes located at the pancreatic head.

Figure 12

Splenic artery aneurysm. Curved planar reforma-tions depicted the local dilatation of splenic artery (arrow).