SMALL PERIPANCREATIC VEINS - IMPROVED ASSESSMENT IN PANCREATIC-CANCERPATIENTS USING THIN-SECTION PANCREATIC PHASE HELICAL CT

OBJECTIVE, Recent studies have shown evaluation of the small peripancr eatic veins to have potential in improving pancreatic cancer staging. This study was performed to determine the effectiveness of thin-sectio n pancreatic phase helical CT images in visualizing these veins. MATER IALS AND METHODS, Seventy-two patients (30 with pancreatic adenocarcin oma and 42 with no pancreatic disease) underwent dual-phase helical CT with thin-section pancreatic phase acquisition (40-70 sec after IV co ntrast initiation at 3 ml/sec) and hepatic phase acquisition (70-100 s ec). Visualization (with diameter measurement) or nonvisualization of the posterior superior pancreaticoduodenal vein (PSPDV), anterior supe rior pancreaticoduodenal vein (ASPDV), and gastrocolic trunk was recor ded for both acquisitions, We also correlated surgical tumor resectabi lity with the status of the small peripancreatic veins. RESULTS, Visua lization of peripancreatic veins was significantly better on pancreati c phase images than on hepatic phase images for both healthy individua ls (PSPDV, 88% of the veins visualized on the pancreatic phase images versus 50% on the hepatic phase images; ASPDV, 93% on the pancreatic p hase images versus 48% on the hepatic phase images; gastrocolic trunk, 98% on the pancreatic phase images versus 76% on the hepatic phase im ages) and for pancreatic cancer patients (PSPDV, 97% on the pancreatic phase images versus 57% on the hepatic phase images; ASPDV, 77% on th e pancreatic phase images versus 43% on the hepatic phase images) (p < .05). The exception was the gastrocolic trunk in cancer patients (83% on the pancreatic phase images versus 77% on the hepatic phase images) (p > .05). In pancreatic cancer patients, 11 dilated peripancreatic v eins were identified on the pancreatic phase images compared with six on the hepatic phase images. However, only one of the 11 dilated perip ancreatic veins was in a patient with surgically resectable disease. C ONCLUSION, In a dual-phase helical CT protocol, thin-section pancreati c phase images provided visualization of the small peripancreatic vein s that was superior to hepatic phase images, providing further support for the use of this protocol in pancreatic cancer evaluation.