pancreas preoperative ct

OBJECTIVE: To assess the correlation between pancreatic quantitative edge analysis as a surrogate of parenchymal stiffness and the incidence of postoperative pancreatic fistula (POPF), in patients undergoing pancreaticoduodenectomy (PD). METHODS: All consecutive patients who underwent PD at our Institution between March 2018 and November 2019 with an available preoperative CT were included. Pancreatic margin score (PMS) was calculated through computer-assisted quantitative edge analysis on the margins of the pancreatic body and tail (the expected pancreatic remnant) on non-contrast scans with in-house software...

INTRODUCTION: Prepancreatic postduodenal portal vein (PPPV) is a rare congenital variation, with only 17 cases reported in the literature and five of them undergoing pancreaticoduodenectomy (PD). Of these, four were L-shaped PPPV with a thin wall that was difficult to isolate, while only one normal-shaped PPPV was reported previously. For patients undergoing PD, recognizing this variation is important to prevent PPPV injury, which could lead to liver ischemia or intraoperative hemorrhage...

BACKGROUND: Pancreatic cavernous hemangioma (pCH) is a rare type of benign vascular tumor. Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions. CASE SUMMARY: We describe a male patient, age 18, who presented with a pCH. Computed tomography, magnetic resonance imaging, and ultrasound showed cystic space in the tail of the pancreas. A dark spot sign on the T2 weighted image sequence was observed...

PURPOSE: The purpose of this study was to develop a radiomics-signature using computed tomography (CT) data for the preoperative prediction of grade of nonfunctional pancreatic neuroendocrine tumors (NF-PNETs). MATERIALS AND METHODS: A retrospective study was performed on patients undergoing resection for NF-PNETs between 2010 and 2019. A total of 2436 radiomic features were extracted from arterial and venous phases of pancreas-protocol CT examinations. Radiomic features that were associated with final pathologic grade observed in the surgical specimens were subjected to joint mutual information maximization for hierarchical feature selection and the development of the radiomic-signature...

BACKGROUND: Insulinoma in women during pregnancy and postpartum is very rare; approximately 65% of cases are diagnosed early in pregnancy and ~ 35% immediately after delivery, few being found in middle or late pregnancy, likely due to increased insulin resistance seen after early-stage pregnancy. We successfully treated a case of insulinoma in which severe hypoglycemic coma immediately after delivery occasioned detailed investigation and diagnosis. CASE PRESENTATION: Our patient experienced hypoglycemic coma in the 3rd month of pregnancy (initially considered due to her hyperemesis gravidarum) that improved spontaneously during the gestational period...

BACKGROUND: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare bile duct neoplasm characterized by an intraluminal papillary growth pattern in bile ducts and is considered a biliary counterpart of intraductal papillary mucinous neoplasm of the pancreas. CASE DESCRIPTION: We report here two cases. (1) A case of a 34-year-old woman who presented with complaints of pain in the abdomen, jaundice, and pruritus. Further radiological investigations revealed the possibility of an IPNB, which was confirmed on histopathology...

In patients with chronic pancreatitis, pancreatic calcification is a risk factor for diabetes development, poor islet yield, and metabolic outcomes after total pancreatectomy with islet autotransplantation (TPIAT). We investigated whether calcification pattern based on computed tomography is associated with outcomes using our database of 200 consecutive TPIAT procedures. Three groups were compared: noncalcification (NC); focal calcification (FC), limited to the pancreas head, body, or tail; and diffuse calcification (DC), with calcification in >2 sections...

This study aims to investigate the reliability of radiomic features extracted from contrast-enhanced computer tomography (CT) by AX-Unet, a pancreas segmentation model, to analyse the recurrence of pancreatic ductal adenocarcinoma (PDAC) after radical surgery. In this study, we trained an AX-Unet model to extract the radiomic features from preoperative contrast-enhanced CT images on a training set of 205 PDAC patients. Then we evaluated the segmentation ability of AX-Unet and the relationship between radiomic features and clinical characteristics on an independent testing set of 64 patients with clear prognoses...

PURPOSE: Anatomical and molecular staging strategies are needed for the personalized treatment of localized pancreatic ductal adenocarcinoma (PDAC). This study evaluated the performance of [68  Ga]Ga-FAPI-04 and [18 F]F-FDG PET/CT on the disease staging and prognostic value of patients with localized PDAC on contrast-enhanced (CE)-CT images. METHODS: Patients with suspected localized PDAC on CE-CT were recruited for static [68  Ga]Ga-FAPI-04 and 18 [F]F-FDG and PET/CT, and select patients underwent simultaneous 60-min dynamic 68  Ga-FAPI-04 PET/CT...

BACKGROUND: Although many formulas for predicting postoperative pancreatic fistula (POPF) have been introduced, POPF is generally predicted during pancreatic surgery due to pancreatic texture. This study was designed to verify the correlation between Hounsfield units (HU) and pancreatic texture and to suggest a fistula risk score (FRS) that can be used before surgery. METHODS: Data from 545 patients who underwent pancreatoduodenectomy for malignant disease between January 2008 and December 2019 were retrospectively reviewed...

INTRODUCTION: Pancreatic follicular dendritic cell sarcoma (FDCS) is an exceptionally rare and low-to-moderate malignancy, with only seven reported cases to date. Clinical diagnosis of FDCS is challenging due to the lack of distinct biological and radiographic features. CASE PRESENTATION: A 67-year-old woman presented to the hospital with a 4-day history of severe abdominal pain. Imaging studies (CT and MRI) revealed a large cystic mass located at the tail of the pancreas, which was suspected to be myeloid sarcoma (MS) based on EUS and CT-guided pancreatic puncture...

BACKGROUND: Pancreas divisum (PD) is a congenital anomaly that occurs due to failure of fusion of the dorsal and ventral pancreatic ductal systems.1-3 In PD, pancreatic juice drains mainly through the minor papilla via the dorsal duct, leading to high intraductal pressure, which can cause pancreatitis.1-3 We report a case of PD that underwent preoperative decompression using endoscopic minor papilla sphincterotomy (EMPS) before laparoscopic distal pancreatectomy (LDP) for pancreatic cancer...

Serous cystadenoma (SCA) is the most common cystic neoplasm of the pancreas. Serous cystadenoma is best diagnosed by imaging with computed tomography scan. Fine-needle aspiration cytology is required for definitive preoperative diagnosis. Serous cystadenoma may be sometime difficult to differentiate from pancreatic neuroendocrine tumor (PNET) in the preoperative stage. Differentiating the two entities are important for proper treatment strategy. Serous cystadenoma may be managed in expectant observation. However, all PNETs will need surgical treatment including pancreaticoduodenectomy (PD)...

Careful preoperative planning is key in minimally invasive radical antegrade modular pancreatosplenectomy (MI-RAMPS). This retrospective study aims to show the practical implications of computed tomography distance between the right margin of the tumor and either the left margin of the spleno-mesenteric confluence (d-SMC) or the gastroduodenal artery (d-GDA). Between January 2011 and June 2022, 48 minimally invasive RAMPS were performed for either pancreatic cancer or malignant intraductal mucinous papillary neoplasms...

Previously considered as one of the less-invasive subtypes of intraductal papillary mucinous neoplasm, intraductal oncocytic papillary neoplasm (IOPN) has recently been acknowledged as a new entity of pancreatic tumor. We herein present a case of preoperatively diagnosable IOPN invasion in the stomach and colon. A 78-year-old woman was referred to our hospital for evaluation of anorexia and gastroesophageal reflux. Upper gastrointestinal endoscopy revealed a gastric subepithelial lesion with ulcerated mucosa that required hemostasis...

INTRODUCTION: The portal vein (PV) originates behind the neck of the pancreas, where it is formed classically by the union of the superior mesenteric vein (SMV) and the splenic vein (SV) [1]. It courses upwards towards the liver in the free margin of the lesser omentum, the hepatoduodenal ligament, along with other structures of the portal triad, i.e. proper hepatic artery (PHA) and common bile duct (CBD) anterior to it [1]. The PV is found posterior to the PHA and CBD. The abdominal aorta perfuses abdominal viscera via three ventral branches celiac trunk (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA)...

BACKGROUND: Portal Annular Pancreas (PAP) is a relatively uncommon entity with 4% reported incidence. Pancreaticoduodenectomy is challenging in cases with PAP and is associated with higher postoperative pancreatic fistula rate and overall morbidity. PAP is classified according to the pattern and location of fusion around the portal vein as-supra-splenic, infra-splenic & mixed fusion type. Also, the ductal anatomy can vary as pancreatic duct present only in the ante-portal portion or only in the retro-portal portion or ducts in both ante and retro-portal portion...

BACKGROUND: Intracholecystic papillary neoplasm (ICPN) is a rare tumor first classified by the World Health Organization in 2010. ICPN is a counterpart of the intraductal papillary mucinous neoplasm of the pancreas and intraductal papillary neoplasm of the bile duct. Previous reports on ICPN are limited; thus, the diagnosis, surgical intervention, and prognosis are controversial. Here, we report an extensively invasive gallbladder cancer arising in ICPN treated with pylorus-preserving pancreaticoduodenectomy (PPPD) and extended cholecystectomy...

BACKGROUND: Primary abdominal and retroperitoneal cavernous hemangioma is a vascular tumor and rarely seen in the clinic. Due to the lack of specific imaging features, retroperitoneal cavernous hemangioma cannot be diagnosed accurately. Some symptoms may develop with the enlargement of lesion volume or the occurrence of complications such as rupture or oppression. We report here a special case who was admitted with chronic abdominal pain. Admission examination suggested a retroperitoneal lymphatic duct cyst...

PURPOSE: This study aimed to characterize the clinical and imaging findings of intraductal oncocytic papillary neoplasm of the pancreas (IOPN-P) compared to those of intraductal papillary mucinous adenoma/carcinoma (IPMA/IPMC). METHODS: This multi-institutional retrospective study reviewed the clinical, imaging, and pathological findings of 21 patients with pathologically proven IOPN-P. Twenty-one computed tomography (CT) and magnetic resonance imaging, and seven 18 F-fluorodeoxyglucose (FDG)-positron emission tomography were performed before surgery...