Kocaeli Med J. 2021; 10(1): 23-29 | DOI: 10.5505/ktd.2021.22230

The Role of Abdominal Tomography, Dynamic Magnetic Resonance Ýmaging and Endoscopic Retrograde Cholangiopancreatography in Periampullary Tumors

Suade Ozlem Badak¹, Hakan Yüceyar², Elmas Kasap², Gökhan Pekindil^3
1Rheumatology, Department of Internal Medicine, Adana City Training and Research Hospital, Adana, Turkey
²Department of Gastroenterology, Department of Internal Medicine, Celal Bayar University Faculty of Medicine, Manisa, Turkey
³Department of Radiology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey

INTRODUCTION: The incidence of pancreatic and periampullary cancers have been increasing since the mid 20th century and the mortality of these cancers have remained high levels. Pancreatic and periampullary cancers are five percent of gasrointestinal cancers and two percent of all the cancers. Evaluation of early diagnosis and the probability of tumor resection is important in these cancers; because the only chance of cure in periampullary zone neoplasms are surgery. The target of our study is to determine the differences between abdominal CT, Dynamic magnetic resonance and retrograde cholangiopancreatography roles in periampullar zone tumors.
METHODS: 20 periampullary zone tumor patients which are diagnosed and followed between 2009 and 2011 are included in our study.
RESULTS: In our study, we detected 75% sensitivity of CT, 85% sensitivity of MRI and 100% sensitivity of ERCP in detecting periampullary tumors. Compared with CT and MRI, ERCP had the highest detection superiority in ampulla wattled tumors.
DISCUSSION AND CONCLUSION: Our study shows that ERCP is more successful in detecting periampullar tumors than CT and MR also MR’s ability of detecting periampullary cancers is more than CT. Besides MR and CT is beneficial to determine staging and spreading of tumor. But ERCP has the advantage in to define the level of bile duct obstruction and the cause of the obstruction. Also ERCP gives us the advantage of to collect cytologic specimen and the cure chance at the same seance.

Keywords: Periampullar tumors, computed tomography, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography

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Periampuller Tümörlerde Batýn Tomografisi, Dinamik Manyetik Rezonans Görüntüleme ve Endoskopik Retrograd Kolanjiopankreatografinin Rolü

Suade Ozlem Badak¹, Hakan Yüceyar², Elmas Kasap², Gökhan Pekindil^3
1Adana Þehir Eðitim ve Araþtýrma Hastanesi, Ýç Hastalýklarý Ana Bilim Dalý, Romatoloji Bilim Dalý, Adana, Türkiye
²Celal Bayar Üniversitesi Týp Fakültesi, Ýç Hastalýklarý Ana Bilim Dalý, Gastroenteroloji Bilim Dalý, Manisa, Türkiye
³Celal Bayar Üniversitesi Týp Fakültesi, Radyoloji Ana Bilim Dalý, Manisa, Türkiye

GÝRÝÞ ve AMAÇ: Pankreatik ve periampuller kanserler mortalite oranlarý oldukça yüksek düzeylerde seyreden kanserlerdir. Bütün gastrointestinal kanserlerin %5’ini, tüm kanserlerin yaklaþýk %2’sini oluþtururlar. Periampuller bölge neoplazmlarýnýn cerrahi tedavisinin uygulanabilmesi için erken taný ve tümör rezektabilitesinin deðerlendirilmesi esas teþkil etmektedir. Bu çalýþmanýn amacý periampuller tümörlü olgularda; Batýn Tomografisi, Dinamik Manyetik Rezonans Görüntüleme ve Endoskopik Retrograd Kolanjio Pankreatografinin rolünü karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: 2009-2011 yýllarý arasýnda periampuller tümör ön tanýsý ile izlenen ve ERCP, BT, MRG tetkikleri yapýlan 20 olgu dahil edilmiþtir.
BULGULAR: Çalýþmamýzda periampuller bölge tümörlerini saptamada BT’nin duyarlýlýðýný %75, MRG’nin duyarlýlýðýný %85, ERCP'nin duyarlýlýðýný ise %100 olarak saptadýk. ERCP’nin, BT ve MRG ile karþýlaþtýrýldýðýnda en büyük saptama üstünlüðünün, ampulla vateri tümörlerinde olduðu görüldü.
TARTIÞMA ve SONUÇ: Periampuller tümörü saptamada ERCP’nin, BT ve MRG’den; MRG’nin tespit oranýnýn ise BT’ye göre biraz daha fazla olduðu görüldü. MRG ve BT’nin hastalýk bulgularýnýn yaygýnlýðý ile evrelemesinde; ERCP’nin ise safra yolu obstrüksiyon seviyesi ve nedenini belirlemede, sitolojik örnek alma ve ayný seansta terapötik yaklaþýmda bulunma gibi avantajlarý bulunmaktadýr.

Anahtar Kelimeler: Periampuller tümörler, bilgisayarlý tomografi, manyetik rezonans görüntüleme, endoskopik retrograd kolanjiopankreatografi

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