Early Detection of Pancreatic Adenocarcinoma Using Triple-phase contrast-enhanced Computed Tomography: A Case-control Study.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Pancreas Pub Date : 2026-10-01 DOI:10.1097/MPA.0000000000002712

Tsuyoshi Hayashi, Yoshihisa Kodama, Yasuo Sakurai, Hajime Yamazaki, Yukiko Takigawa, Haruka Toyonaga, Tatsuya Ishii, Toshifumi Kin, Kuniyuki Takahashi, Akio Katanuma

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引用次数: 0

Abstract

Objectives: To investigate the imaging findings of the triple-phase computed tomography (CT), which was performed prior to definitive diagnoses in patients with Pancreatic ductal adenocarcinoma (PDAC).

Methods: The single-center, retrospective, case-control study included patients with PDAC who underwent triple-phase CT 3-36 months prior to definitive diagnosis (pre-diagnostic CT) between January 2007 and March 2018 in Teine Keijinkai hospital. Triple-phase CT in sex- and age-matched patients without PDAC appearance in a 4:1 ratio were selected as controls. Findings were detected from each of the five divided pancreatic sections on pre-diagnostic CT by radiologists' reviews, and were analyzed by comparison with CT at the definitive diagnosis (diagnostic CT) to investigate risk ratios.

Results: Pre-diagnostic CTs were investigated in 190 and 760 sections with 38 PDAC and 152 control patients. In the diagnostic CT, 50 PDAC-positive and 900 negative sections were detected, respectively. In pre-diagnostic CT review, some findings were shown in 17 (34.0%) and 18 (2.0%) sections among PDAC-positive and negative sections, respectively, and the total number of findings was 46 and 28 in PDAC-positive and negative sections, respectively. Finally, different attenuation of pancreatic parenchyma in each phase, MPD stenosis, and focal pancreatic parenchymal atrophy were significantly correlated with the risk of PDAC.

Conclusions: While some findings may already appear on the pre-diagnostic CT in one-third of the PDAC-positive sections, an accurate and detailed review in triple-phase CT is indispensable to detect early PDAC in clinical practice.

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使用三期增强计算机断层扫描早期检测胰腺腺癌：一项病例对照研究。

目的：探讨胰腺导管腺癌（PDAC）患者在确诊前的三期计算机断层扫描（CT）的影像学表现。方法：采用单中心、回顾性、病例对照研究，纳入2007年1月至2018年3月在天津Keijinkai医院确诊前3-36个月行三期CT（预诊断CT）的PDAC患者。选择性别和年龄相匹配且无PDAC表现的三期CT患者为对照，比例为4:1。通过放射科医生的复查，从预诊断CT上的五个划分的胰腺切片中检测结果，并通过与明确诊断的CT（诊断CT）进行比较分析，以调查风险比。结果：对190和760个切片进行了预诊断ct检查，其中38例为PDAC， 152例为对照。在诊断CT上，pdac阳性切片50片，阴性切片900片。在诊断前的CT复查中，pdac阳性和阴性切片中分别有17（34.0%）和18（2.0%）个发现，pdac阳性和阴性切片中分别有46和28个发现。最后，各期胰腺实质的不同衰减、MPD狭窄、局灶性胰腺实质萎缩与PDAC的发生风险显著相关。结论：虽然在三分之一的PDAC阳性切片中，一些发现可能已经出现在诊断前的CT上，但在临床实践中，准确而详细的三期CT检查对于早期发现PDAC是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreas 医学-胃肠肝病学

CiteScore

4.70

自引率

3.40%

发文量

289

审稿时长

1 months

期刊介绍： Pancreas provides a central forum for communication of original works involving both basic and clinical research on the exocrine and endocrine pancreas and their interrelationships and consequences in disease states. This multidisciplinary, international journal covers the whole spectrum of basic sciences, etiology, prevention, pathophysiology, diagnosis, and surgical and medical management of pancreatic diseases, including cancer.