SPIRAL CT DURING PHARMACOANGIOGRAPHY WITH ANGIOTENSIN-II IN PATIENTS WITH PANCREATIC DISEASE - TECHNIQUE AND DIAGNOSTIC EFFICACY

Purpose: To compare the diagnostic efficacy of pancreatic pharmacoangi ographic CT using angiotensin II with conventional angiographic CT. Ma terial and Methods. Eighteen patients with space-occupying pancreatic disease were examined in this study. Pharmacoangiographic CT was perfo rmed with a 1-3-mu g/6-ml solution of angiotensin II injected through a catheter into the celiac artery during spiral CT. Results: In 17 of the 18 (94%) patients, the area of pancreatic parenchymal enhancement was the same or larger at pharmacoangiographic CT than at conventional angiographic CT. The attenuation value of the pancreatic parenchyma w as significantly increased at pharmacoangiographic CT (p=0.0010). Alth ough the attenuation value of tumors was also increased on images obta ined after the injection of angiotensin II, the tumor-to-pancreas cont rast was significantly greater at pharmacoangiographic CT (p=0.0479). The mean differences in attenuation between tumor and pancreas at angi ographic CT with and without angiotensin II were respectively 182 HU a nd 115 HU. Conclusion: Pharmacoangiographic CT with angiotensin II pro ved superior to conventional angiographic CT in the diagnosis of pancr eatic disease. We therefore recommend it as a supplementary technique at the angiographic examination of patients with suspected pancreatic tumor.