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Pancreatic invasion of gastric carcinoma in emaciated patients: The value of combined analysis with CT and upper gastrointestinal series

Abstract

The obliteration of a fat plane between the gastric carcinoma and the pancreas is a major criterion on CT scan for pancreatic invasion of gastric carcinoma. However, this sign is not always a reliable indicator of invasion, as the patients with gastric carcinoma are often emaciated, producing a false positive CT findings. The purpose of our study is to improve the diagnostic accuracy of pancreatic invasion of gastric carcinoma in cases which the fat plane between the gastric carcinoma and the pancreas is obliterated in conventional CT scan. The authors performed lateral decubitus as well as supine CT scans and upper gastrointestinal series(UGIS) in 49 pathologically proven cases in which the fat plane was obliterated between the gastric carcinoma and the pancreas on conventional supine CT scan. Pancreatic invasion was suggested when the fat plane was obliterated persistently in the lateral decubitus view as well as the spine CT images and the involved gastric wall and adjacent pancreas maintained constant approximation despite postural change(CT+), and when the gastric tumor moved downward on the erect view of the UGIS no more than 1.5 times the height of the first lumbar vertebral body(UGIS+). Among 49 cases in which the fat plane between  More>>
Authors:
Lee, Jae Mun; Kim, Hyun; Kim, Choon Yul; Bahk, Yong Whee [1] 
  1. Catholic University Medical College, Seoul (Korea, Republic of)
Publication Date:
Mar 15, 1992
Product Type:
Journal Article
Resource Relation:
Journal Name: Journal of the Korean Radiological Society; Journal Volume: 28; Journal Issue: 2; Other Information: 15 refs, 4 figs, 3 tabs
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; PANCREAS; PATHOLOGY; PATIENTS; STOMACH
OSTI ID:
21148572
Country of Origin:
Korea, Republic of
Language:
Korean
Other Identifying Numbers:
Journal ID: ISSN 1738-2637; DBSHAH; TRN: KR0900830028039
Submitting Site:
KRN
Size:
page(s) 223-228
Announcement Date:
May 14, 2009

Citation Formats

Lee, Jae Mun, Kim, Hyun, Kim, Choon Yul, and Bahk, Yong Whee. Pancreatic invasion of gastric carcinoma in emaciated patients: The value of combined analysis with CT and upper gastrointestinal series. Korea, Republic of: N. p., 1992. Web.
Lee, Jae Mun, Kim, Hyun, Kim, Choon Yul, & Bahk, Yong Whee. Pancreatic invasion of gastric carcinoma in emaciated patients: The value of combined analysis with CT and upper gastrointestinal series. Korea, Republic of.
Lee, Jae Mun, Kim, Hyun, Kim, Choon Yul, and Bahk, Yong Whee. 1992. "Pancreatic invasion of gastric carcinoma in emaciated patients: The value of combined analysis with CT and upper gastrointestinal series." Korea, Republic of.
@misc{etde_21148572,
title = {Pancreatic invasion of gastric carcinoma in emaciated patients: The value of combined analysis with CT and upper gastrointestinal series}
author = {Lee, Jae Mun, Kim, Hyun, Kim, Choon Yul, and Bahk, Yong Whee}
abstractNote = {The obliteration of a fat plane between the gastric carcinoma and the pancreas is a major criterion on CT scan for pancreatic invasion of gastric carcinoma. However, this sign is not always a reliable indicator of invasion, as the patients with gastric carcinoma are often emaciated, producing a false positive CT findings. The purpose of our study is to improve the diagnostic accuracy of pancreatic invasion of gastric carcinoma in cases which the fat plane between the gastric carcinoma and the pancreas is obliterated in conventional CT scan. The authors performed lateral decubitus as well as supine CT scans and upper gastrointestinal series(UGIS) in 49 pathologically proven cases in which the fat plane was obliterated between the gastric carcinoma and the pancreas on conventional supine CT scan. Pancreatic invasion was suggested when the fat plane was obliterated persistently in the lateral decubitus view as well as the spine CT images and the involved gastric wall and adjacent pancreas maintained constant approximation despite postural change(CT+), and when the gastric tumor moved downward on the erect view of the UGIS no more than 1.5 times the height of the first lumbar vertebral body(UGIS+). Among 49 cases in which the fat plane between the gastric carcinoma and the pancreas was obliterated on supine CT scan, pancreatic invasion was confirmed pathologically in 11 cases(22.4%). Eight of 11 cases proven as pancreatic invasion were correctly diagnosed as pancreatic invasion by this combined analysis(CT+/UGIS+, 72.7%). Twenty seven of 38 cases proven as no pancreatic invasion were correctly diagnosed as no pancreatic invasion(CT-/UGIS-, 71.1%). Twelve cases showed CT+/UGIS- or CT-/UGIS+, so it was inconclusive whether there was invasion or not. The overall diagnostic accuracy was 71.4%. In conclusion, combined analysis with supine and lateral decubitus CT and UGIS is useful for improving diagnostic accuracy for pancreatic invasion by gastric carcinoma in patients of which the fat plane between the gastric carcinoma and the pancreas is obliterated on conventional supine CT.}
journal = []
issue = {2}
volume = {28}
place = {Korea, Republic of}
year = {1992}
month = {Mar}
}