Abstract
We aimed to evaluate the imaging findings of hepatic metastases from pancreatic cancers, especially wedge-shaped enhancement and its etiology. Dynamic CT and MR images were performed in 87 patients with liver metastases from pancreatic carcinomas, and CT during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) in 51 patients. Liver metastases were multiple in 84 patients (97%) and solitary in only three (3%). In 44 of 87 patients (51%), all liver metastases showed ring-like enhancement compatible with metastatic adenocarcinomas on dynamic CT and/or dynamic MR imaging. In 37 patients, more than one metastatic lesion showed wedge-shaped contrast enhancement on dynamic CT, dynamic MRI and CTHA, and wedge-shaped perfusion defect on CTAP adjacent to metastatic tumors. Six patients showed multiple wedge-shaped enhancements, which were initially diagnosed as multiple arterioportal shunts (AP shunts). However, metastatic tumors appeared within the area of wedge-shaped enhancement and increased in size on follow-up CT and/or MR images. After all, 43 of 87 patients (49%) had AP shunt like contrast enhancement adjacent to liver metastases. Liver metastases from pancreatic carcinomas frequently show transient wedge-shaped enhancement, and should not be misdiagnosed as nontumorous arterioportal shunts.
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Matsuno S, Egawa S, Fukuyama S et al. (2004) Pancreatic cancer registry in Japan. 20 years of experience. Pancreas 28:219–230
Sperti C, Pasquali C, Piccoli A et al. (1997) Recurrence after resection for ductal adenocarcinomas. World J Surg 21:195–200
Takamori H, Ikeda O, Kanemitsu K et al. (2004) Preoperative detection of liver metastases secondary to pancreatic cancer. Utility of combined helical computed tomography during arterial portography with biphasic computed tomography—associated hepatic arteriography. Pancreas 29:188–192
Matsui O, Kadoya M, Suzuki M et al. (1983) Dynamic sequential computed tomography during arterial portography in the detection of hepatic neoplasms. Radiology 146:721–727
Bluemke DA, Soyer P, Fishman EK (1995) Nontumorous low-attenuation defects in the liver on helical CT during arterial portography: frequency, location, and appearance. AJR 164:1141–1145
Matsui O, Kadoya M, Yoshikawa J et al. (1995) Aberrant gastric venous drainage in cirrhotic livers: imaging findings in focal spared area of liver parenchyma. Radiology 197:345–349
Matsuo M, Kanematsu M, Inaba Y et al. (2001) Preoperative detection of malignant hepatic tumors: value of combined helical CT during arterial portography and biphasic CT during hepatic arteriography. Clin Radiol. 56:138–145
Ueda K, Matsui O, Kadoya M et al. (1999) Differentiation of hypervascular hepatic pseudolesions from hepatocellular carcinoma: value of single-level dynamic CT during hepatic arteriography. J Comput Assist Tomogr 23:63–68
Colagrande S, Centi N, Villa GL, Villari N (2004) Transient hepatic differences. AJR 183:459–464
Kim HJ, Kim AY, Kim TK et al. (2005) Transient hepatic attenuation differences in focal hepatic lesions: dynamic CT features. AJR 184:83–90
Gabata T, Kadoya M, Matsui O et al. (2001) Dynamic CT of hepatic abscesses: significance of transient segmental enhancement. AJR 176:675–679
Arai K, Kawai K, Kohda W, Tatsu H, Matsui O, Nakahama T (2003) Dynamic CT of acute cholangitis; early inhomogeneous enhancement of the liver. AJR 181:115–118
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Gabata, T., Matsui, O., Terayama, N. et al. Imaging diagnosis of hepatic metastases of pancreatic carcinomas: significance of transient wedge-shaped contrast enhancement mimicking arterioportal shunt. Abdom Imaging 33, 437–443 (2008). https://doi.org/10.1007/s00261-007-9280-7
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DOI: https://doi.org/10.1007/s00261-007-9280-7