Abstract：To investigate the imaging characteristics and diagnostic value of carcinomas of pancreatic head and ampulla with multi-slice CT. Methods: Thirty-nine patients confirmed by surgery and pathology were retrospectively studied, including 29 cases with carcinoma of the head of the pancreas and 10 with ampullary carcinoma, male patients 24, female 15, age ranged from 39~81 years; mean age 65 years. They all underwent the pre- and post-enhanced multi-phase CT examination before operation with Siemens Sensation 4 or 16 multi-slice scanner. On the base of transverse images and with multi-plannar reconstruction and other post-processing techniques, the imaging characteristics of the two groups were analyzed retrospectively and compared. Pre-operative diagnostic accuracy was evaluated statistically. Results: Main CT appearances of this group of cases: ①Ampullary carcinoma manifested as a small mass and was prone to protruding into duodenum, whereas the center of pancreatic head carcinoma was located in pancreas. ②Relationship between tumors and choledochopancreatic ducts and peripancreatic vessels were showed clearly. ③Getting together of the two ducts(distance between distal ends of the dilated common bile duct and the dilated main pancreatic duct≤5mm) was usually seen in ampullary carcinomas, while separation of the two ducts(distance between distal ends of the two dilated ducts＞5mm) was mostly seen in carcinomas of pancreatic head. In our patients, 96.9% tumors of pancreatic head and 90% ampullary masses were displayed before operation by multi-slice CT. The pre-operative diagnostic accuracy for carcinomas of pancreatic head and ampulla with multi-slice CT was 93.1% and 90% respectively. Conclusion: Multi-slice CT can depict the imaging characteristics of carcinomas of pancreatic head and ampulla, and play an important role in pre-operative diagnosis and staging.
2007, Vol. 18 
