Giá trị của cắt lớp vi tính đa dãy trong đánh giá giai đoạn trước phẫu thuật triệt căn điều trị ung thư vùng đầu tụy

Abstract

Objective: To evaluate the value of 320-slice computed tomography in grading and prognosis before radical operation treatment of cancers in pancreatic head area. Subject and method: A prospective, descriptive study up on patients with cancer in pancreatic head area who underwent pancreaticoduodenectomy with standard lymphadenectomy in 108 Military Central Hospital  from July 2016 to July 2019. Result: 320-slice computed tomography discovered the tumors in 95.1% cases including: Grade I 44.8%, grade II 41.4% and grade III 13.8%. It was hightly accurate with pathologic results in diagnosis tumors location (Kappa = 0.69), and veins invasion with a sensitivity of 77.8% and specificity of 96.2%. Moreover, it was helpful in observing the anatomical variations of hepatic artery (11.5% common hepatic artery or replaced right hepatic artery arising from the superior mesenteric artery). However, it was less efficient in diagnosis lympho nodes metastasis (sensitivity, specificity and accuracy were 48.1%, 67.6% and 59% respectively) and in preoperative grading (Kappa = 0.18). Conclusion: In preoperative diagnose of pancreatic head area cancers, 320-slice computed tomography had hight value discovering tumors location and veins invasion, but its ability in measuring lympho nodes metastasis and grading were limited.