7128 Three-dimensional ct pancreatography (3d-ctp) of pancreatic diseases

• Published in: Gastrointestinal endoscopy 2000-04, Vol.51 (4), p.AB274-AB274
• Main Authors: Okita, Yoshio, Okahisa, Toshiya, Suzuki, Masaharu, Omoya, Toshihiro, Kusaka, Yoshihiro, Tadatsu, Masaya, Tsutsui, Akemi, Muguruma, Naoki, Shibata, Hiroshi, Okamura, Seisuke, Ito, Susumu, Ueno, Junji
• Format: Article
• Language: English
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(00)14799-6

Background: Endoscopic retrograde pancreatograpy (ERP) is common techniques used for the diagnosis of pancreatic diseases. However, conventional ERP under fluoroscopy (c-ERP) provides only two-dimensional projection images of the pancreatic ducts. Recent advances in the volumetric CT enable us to get whole pancreatic deta. CT images provide better tissue characterization than fluoloscopy images and ability to create 3D images from its data. Using volumetric CT technique with ERP is thought to be able to provide additional information. Aims: The present study was undertaken to assess the usefulness of 3D-CTP in the diagnosis of pancreatic diseases. Methods: The subjects of this study were 22 patients with pancreatic disease (5 with pancreatic cancer, 5 with chronic pancreatitis and 12 with pancreatic cystic disease). After c-ERP with balloon-catheter, 3D-CTP was performed with volumetric CT within a single brethhold period. Several 3D images per a case were made with the method of shaded surface display(SSD), multiplanar reconstruction (MPR) and maximum intensity projection (MIP) from CT data. Results: Images with SSD and MIP allowed us to realize the pancreatic ducts three dimensionally. The main pancreatic duct (MPD) was visualized three dimensionaly, but the side branches were not enough (see table).Images with MPR provide good visualization of both the pancreatic duct and its parenchyma. In the case of pancreatic cyst, the communication between the cyst and MPD was detected with 3D-CTP. In the case of mutin producing tumor, papillary intraductal tumor was detected more clearly. In the case of pancreatic cancer, dilated pancreatic ducts proximal to the stenosis were observed by 3D-CTP, which could not be visualized by c-ERP, with advantage of contrast resolution of CT. Conclusion: 3D-CTP provides three dimensional images of pancreatic ducts and its parenchyma. It provides additional information about the pancreatic pathologies to c-ERP. 3D-CTP with c-ERP seems to be applicable to simulation for the surgery. The accuracy and clinical usefulness of 3D-CTP will elevated by using improved devices under optimal condition.