膵臓―膵管癌

Imaging of pancreatic ductal adenocarcinoma

膵管癌の画像診断において重要となる危険因子やCT・MRI所見について解説する。

Patients with pancreatic adenocarcinoma require early recognition and an accurate diagnosis. However, there are many cases in which diagnosis is very difficult. On dynamic contrast-enhanced computed tomography（CT）, there are cases in which a pancreatic adenocarcinoma appears as a iso-attenuating mass compared with the pancreatic parenchyma, and also cases in which secondary signs such as a dilated main pancreatic duct, a contrasting effect between the proximal and distal pancreatic parenchyma（obstructive pancreatitis）, or focal atrophy of the pancreatic parenchyma, by themselves provide clues for diagnosis. In recent years, reports that localized fatty degeneration of pancreatic parenchyma is a finding suggestive of pancreatic carcinoma in situ have also been seen.