Assessing the resectability of XXXX : comparision of dual-phase helical CT arterial portography with conventional angiography.

@entity1 @entity850 @entity5 @entity1124
OBJECTIVE: To evaluate the respective value of dual-phase helical CT arterial portography (CTAP) and conventional angiography in preoperative predicting resectability of @entity1124 . SUBJECTS AND METHODS: Tumor resectability was prospectively evaluated in 54 @entity1 with pathologically proven @entity1124 who later underwent surgery. Both dual-phase helical CT scanning and selective angiography were obtained in each @entity1 preoperatively. For optimal enhancement of pancreas and major peripancreatic vessels, two catheters connected to an automatic injector via a Y-shaped tube were placed selective angiography, one in celiac trunk, the other in superior mesenteric artery. Then the @entity1 underwent dual-phase helical CTAP of pancreas and liver. The criteria of irresectability for CTAP include: @entity5 diameter > or = 5 cm, extrapancreatic invasion, distant metastases and vascular involvement (occlusion, @entity850 or semicircular encasement of superior mesenteric artery, hepatic artery, splenic artery, celiac axis; portal vein, superior mesenteric vein or splenic vein). The results of both modalities were correlated with findings from surgery or pathology. RESULTS: Thirty-eight of 54 @entity1 had nonresectable disease. In prediction the irresectability, sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 94.7%, 100%, 100%, 88.9%, 96.3% respectively for helical CTAP and 63.2%, 93.89%, 96.0%, 51.7%, 72. 2% respectively for selective angiography. In assessing vascular involvements, dual-phase helical CTAP was also superior to selective angiography. CONCLUSION: Dual-phase helical CTAP is superior to angiography in assessing resectability of @entity1124 . The combination of the two modalities may further improve overall creatic
