Detection of liver metastases secondary to pancreatic cancer: utility of combined helical computed tomography during arterial portography with biphasic computed tomography-assisted hepatic arteriography

作者：Ikuta Yoshiaki; Takamori Hiroshi; Ikeda Osamu; Tanaka Hiroshi; Sakamoto Yasuo; Hashimoto Daisuke; Ozaki Nobuyuki; Nakahara Osamu; Furuhashi Satoshi; Abe Shinya; Beppu Toru; Shimada Shinya; Yamashita Yasuyuki; Baba Hideo^*

来源：Journal of Gastroenterology, 2010, 45(12): 1241-1246.

DOI：10.1007/s00535-010-0285-6

• Pancreatic cancer
• Liver metastasis
• CTHA
• CTAP

This study was designed to define the diagnostic advantage of computed tomography during arterial portography (CTAP) combined with computed tomography-assisted hepatic arteriography (CTHA) for the preoperative detection of liver metastases secondary to pancreatic cancer compared with that of multidetector computed tomography (MDCT).
From January 2002 to December 2007, we retrospectively studied 197 consecutive patients with pancreatic cancer. MDCT was performed on 192 patients prior to preoperative visceral angiography; 153 patients underwent CTAP + CTHA at the time of preoperative angiography.
Liver metastases were identified in 39 patients by means of MDCT. Of the 153 patients who had no evidence of liver metastases on MDCT, 129 patients underwent CTAP + CTHA, and 53 of these 129 patients (41.1%) were diagnosed as having liver metastases that could not be detected by MDCT. These tumors missed by MDCT ranged from 3 to 15 mm in size. On CTAP + CTHA, a solitary nodule in the liver was detected in 11 patients, 2 nodules were detected in 6 patients, 3 lesions were detected in 2 patients, and a parts per thousand 4 lesions were detected in 34 patients. The sensitivity and specificity of CTAP + CTHA versus MDCT were 94.2 versus 48.4% and 82.7 versus 97.9%, respectively.
The combination of CTAP and CTHA is useful to confirm liver metastases and can potentially offer more accurate staging of pancreatic cancer compared with MDCT.

• 出版日期2010-12