Skip to main content
SpringerLink
Log in

Significance of perivascular soft tissue around the common hepatic and proximal superior mesenteric arteries arising after pancreaticoduodenectomy: evaluation with serial MDCT studies

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the interval change of perivascular soft tissue (PVST) around the common hepatic and proximal superior mesenteric arteries arising after pancreaticoduodenectomy (PD) and to compare the difference between post operative change (benign PVST) and recurrence (malignant PVST).

Materials and methods

Serial multidetector CT (MDCT) studies in 44 patients who underwent PD for periampullary carcinomas were retrospectively reviewed (Group A). The incidence and interval change of PVST were evaluated and compared to control group (Group B, 21 patients with PD for benign diseases).

Results

PVST was seen in all the 44 patients in Group A, and it was noted in 12 of 21 (57.1%) patients in Group B. Thirteen of 44 (29.5%) patients showed interval enlargement of PVST (malignant PVST), and 12 of 13 developed within 2 years after PD. There was higher incidence of malignant PVST in patients with lymph node metastasis (p < 0.01) and those with pancreas head carcinoma (p < 0.05).

Conclusion

PVST is common after PD regardless of whether patients had malignant or benign diseases. PVST should be monitored for at least 2 years to distinguish recurrence from post operative change. Patients with lymph node metastasis and pancreas head carcinoma had a higher incidence of malignant PVST.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Sohn TA, Yeo CJ, Cameron JL, et al. (2000) Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators. J Gastrointest Surg 4(6):567–579

    Article  PubMed  CAS  Google Scholar 

  2. Sandrasegaran K, Maglinte DD, Howard TJ, Lappas JC (2005) Surgery for chronic pancreatitis: cross-sectional imaging of postoperative anatomy and complications. AJR Am J Roentgenol 184(4):1118–1127

    PubMed  Google Scholar 

  3. Kim JK, Ha HK, Han DJ, Auh YH (2003) CT analysis of postoperative tumor recurrence patterns in periampullary cancer. Abdom Imaging 28(3):384–391

    Article  PubMed  CAS  Google Scholar 

  4. Coombs RJ, Zeiss J, Howard JM, Thomford NR, Merrick HW (1990) CT of the abdomen after the Whipple procedure: value in depicting postoperative anatomy, surgical complications, and tumor recurrence. AJR Am J Roentgenol 154(5):1011–1014

    PubMed  CAS  Google Scholar 

  5. Lepanto L, Gianfelice D, Dery R, Dagenais M, Lapointe R, Roy A (1994) Postoperative changes, complications, and recurrent disease after Whipple’s operation: CT features. AJR Am J Roentgenol 163(4):841–846

    PubMed  CAS  Google Scholar 

  6. Bluemke DA, Fishman EK, Kuhlman J (1992) CT evaluation following Whipple procedure: potential pitfalls in interpretation. J Comput Assist Tomogr 16(5):704–708

    Article  PubMed  CAS  Google Scholar 

  7. Mortele KJ, Lemmerling M, de Hemptinne B, De Vos M, De Bock G, Kunnen M (2000) Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features. Eur Radiol 10(1):123–128

    Article  PubMed  CAS  Google Scholar 

  8. Bluemke DA, Abrams RA, Yeo CJ, Cameron JL, Fishman EK (1997) Recurrent pancreatic adenocarcinoma: spiral CT evaluation following the Whipple procedure. Radiographics 17(2):303–313

    PubMed  CAS  Google Scholar 

  9. Johnson PT, Curry CA, Urban BA, Fishman EK (2002) Spiral CT following the Whipple procedure: distinguishing normal postoperative findings from complications. J Comput Assist Tomogr 26(6):956–961

    Article  PubMed  Google Scholar 

  10. Kelvin FM, Korobkin M, Heaston DK, Grant JP, Akwari O (1983) The pelvis after surgery for rectal carcinoma: serial CT observations with emphasis on nonneoplastic features. AJR Am J Roentgenol 141(5):959–964

    PubMed  CAS  Google Scholar 

  11. Adalsteinsson B, Pahlman L, Hemmingsson A, Glimelius B, Graffman S (1987) Computed tomography in early diagnosis of local recurrence of rectal carcinoma. Acta Radiol 28(1):41–47

    Article  PubMed  CAS  Google Scholar 

  12. Mendez RJ, Rodriguez R, Kovacevich T, Martinez S, Moreno G, Cerdan J (1993) CT in local recurrence of rectal carcinoma. J Comput Assist Tomogr 17(5):741–744

    Article  PubMed  CAS  Google Scholar 

  13. Markus J, Morrissey B, deGara C, Tarulli G (1997) MRI of recurrent rectosigmoid carcinoma. Abdom Imaging 22(3):338–342

    Article  PubMed  CAS  Google Scholar 

  14. Torricelli P, Pecchi A, Luppi G, Romagnoli R (2003) Gadolinium-enhanced MRI with dynamic evaluation in diagnosing the local recurrence of rectal cancer. Abdom Imaging 28(1):19–27

    Article  PubMed  CAS  Google Scholar 

  15. International Union Against Cancer (UICC) (2002) TNM Classification of Malignant Tumors 6th ed. In: Sobin LH, Wittekind Ch, (eds). New York: Willey

  16. Barkin JS, Goldstein JA (1999) Diagnostic approach to pancreatic cancer. Gastroenterol Clin North Am 28(3):709–722

    Article  PubMed  CAS  Google Scholar 

  17. Furukawa H, Kosuge T, Shimada K, Yamamoto J, Ushio K (1977) Helical CT of the abdomen after pancreaticoduodenectomy: usefulness for detecting postoperative complications. Hepatogastroenterology 44(15):849–855

    Google Scholar 

  18. Yamaguchi K, Tanaka M, Chijiiwa K, Nagakawa T, Imamura M, Takada T (1999) Early and late complications of pylorus-preserving pancreaticoduodenectomy in Japan 1998. J Hepatobiliary Pancreat Surg 6(3):303–311

    Article  PubMed  CAS  Google Scholar 

  19. Yeo CJ, Cameron JL, Sohn TA, et al. (1997) Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg 226(3):248–260

    Article  PubMed  CAS  Google Scholar 

  20. Shimizu A, Nakagawa N, Terayama K, et al. (1999) Non-tumorous soft tissue density emerged after surgery for gastric carcinoma; evaluation with CT. Rinsho Hoshasen 44(8):931–937

    Google Scholar 

  21. Manfredi R, Barbaro B, Masselli G, Vecchioli A, Marano P (2004) Magnetic resonance imaging of cholangiocarcinoma. Semin Liver Dis 24(2):155–164

    Article  PubMed  Google Scholar 

  22. Furukawa H, Takayasu K, Mukai K, et al. (1996) Late contrast-enhanced CT for small pancreatic carcinoma: delayed enhanced area on CT with histopathological correlation. Hepatogastroenterology 43(11):1230–1237

    PubMed  CAS  Google Scholar 

  23. Kelekis NL, Makri E, Vassiou A, Patsiaoura K, Spiridakis M, Dalekos GN (2004) Confluent hepatic fibrosis as the presenting imaging sign in nonadvanced alcoholic cirrhosis. Clin Imaging 28(2):124–127

    Article  PubMed  Google Scholar 

  24. Ruf J, Lopez Hanninen E, Oettle H, et al. (2005) Detection of recurrent pancreatic cancer: comparison of FDG-PET with CT/MRI. Pancreatology 5(2–3):266–272

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kousei Ishigami, Kengo Yoshimitsu, Hiroyuki Irie, Tsuyoshi Tajima, Yoshiki Asayama, Masakazu Hirakawa, Daisuke Kakihara, Yoshiyuki Shioyama & Hiroshi Honda

  2. Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yunosuke Nishihara

  3. Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Koji Yamaguchi

Authors
  1. Kousei Ishigami
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kengo Yoshimitsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hiroyuki Irie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tsuyoshi Tajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshiki Asayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masakazu Hirakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daisuke Kakihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshiyuki Shioyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yunosuke Nishihara
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Koji Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Hiroshi Honda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kousei Ishigami.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ishigami, K., Yoshimitsu, K., Irie, H. et al. Significance of perivascular soft tissue around the common hepatic and proximal superior mesenteric arteries arising after pancreaticoduodenectomy: evaluation with serial MDCT studies. Abdom Imaging 33, 654–661 (2008). https://doi.org/10.1007/s00261-008-9359-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-008-9359-9

Keywords

Search

Navigation