Summary
From February to November 1981 the diagnostic relevance of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) was compared prospectively in 75 patients with suspected pancreatic disease. Final diagnosis was confirmed by autopsy, surgery, clinical course, and further laboratory data. Thus it was possible to exclude pancreatic disorders in 32 patients. By ERCP we diagnosed all tumors; sensitivity was 100%. Sensitivity of US and CT were 63% each. In five cases US made the false positive diagnosis” pancreatic malignant tumor” (specifity 93%), CT and ERCP in two cases (specifity 97% each). In chronic pancreatitis specifity of US and ERCP were 100% and specifity of CT was 98%. Sensitivity of ERCP amounted to 93%, CT and US revealed 74% and 52%, respectively. We conclude that ERCP is the best morphologic diagnostic tool in differentiating chronic pancreatitis from pancreatic carcinoma. US is a good screening method and CT reveals good diagnostic results in acute pancreatitis.
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References
Äarimaa M, Mäkelä P (1980) The Diagnosis of Pancreatic and Biliary Malignancy by Endoscopy and Retrograde Cholangiopancreatography. Scand J Gastroenterol 15:205–211
Anacker H, Weiss, H-D, Kramann B, Gmelin E (1981) Die Treffsicherheit der endoskopischen retrograden Pankreatiko-Cholangiographie in der Diagnostik der Pankreaskrankheiten. Dtsch. Med Wochenschr 106:230–233
Andersen BN, Hancke S, Nielsen SA, Schmidt A (1977) The Diagnosis of Pancreatic Cyst by Endoscopic Retrograde Pancreatography and Ultrasonic Scanning. Ann Swg 185:286–289
Ariyama J, Shirakabe H, Shimaguchi S, Autenrieth J (1980) „Kritischer Vergleich der Untersuchungsmethoden bei der Frage nach einem Pankreaskarzinom.“ Fortschr Röntenstr 133, 1:6–9
Barkin J, Vining D, Miale A, Gottlieb S et al. (1977) Computerized Tomography, Diagnostic Ultrasound, and Radionuclide Scanning. JAMA 238:2040–2042
Becker M, Miederer SE, Emons D, Rotthauwe HW (1980) Endoskopisch-retrograde Cholangio-Pankreatikographe im Kindesalter Dtsch med Wschr 105:1055–1060
Bindewald H, Meyer G, Brecht-Krauss D (1980) Zur Treffsicherheit der Pankreassonographie. Med Welt 31, 33:1169–1170
Botzler R, Mahlke R (1981) Die sonographische Pankreasgangdarstellung und ihre klinische Bedeutung. Dtsch Med Wochenschr 106, 3:77–81
Boxdeaton SJR, Ferrucci MT (1973) Radiology of the Pancreas and Duodenum. Saunders, Philadelphia, pp 270–275
Brasch RC, Abols IB, Gooding CA, Filly RA (1980) Abdominal Disease in Children: A comparison of Computed Tomography and Ultrasound. Am J Roentg 153–158
Braun B (1982) Möglichkeiten und Grenzen der Ultraschalldiagnostik in der Gastroenterologie. Z. Gastroenterol 20:53–65
Bryan PP (1982) Appearance of Normal Pancreatic Duct: A study using Real-Time Ultrasound. J Clin Ultrasound 10:63–66
Bücheler E, Montgomery FU, Grabbe E (1982) Röntgendiagnostik des Pankreas. Internist, 23:82–88
Cotton PB (1974) The Normal endoscopic Pancreatogram. Endoscopy 6:64–70
Cotton PB (1977) Progress report ERCP. Gut 18:316–341
Cotton PB, Denyer ME, Kreel L, Husband J, Meire HB, Lees W (1978) Comparative clinical impact of endoscopic pancreatography, grey-scale ultrasonography, and computed tomography (EMI scanning) in pancreatic disease: preliminary report. Gut 19:679–684
Cotton PB, Lees WR, Vallon AG, Cottone M, Croker JR, Chapman M (1980) Gray-Scale Ultrasonography and Endoscopic Pancreatography in Pancrcatic Diagnosis. Radiology 134:453–459
Dale G, Baumann R, Dale M, Weill JP, Kempf F, Gros Ch (1977) Über die Pankreadiagnostik von 52 Patienten mit Ultraschall und ERCP. Diss. Strassburg
Demling L, Koch H, Rösch W (1979) Endoskopisch Retrograde Cholangio Pancreatikographie ERCP. Schattauer, Stuttgart New York
DiMagno EP, Malagelada JR, Taylor WF, Go VL (1977) A prospective comparison of current diagnostic tests for pancreatic cancer. N Engl J Med 297:737–742
Elsborg L, Bruusgaard A, Strandgaard L, Reinicke V (1981) Endoscopic Retrograde Pancreatography and the Exocrine Pancreatic Function in Chronic Alcoholism Scand J Gastroenterol 16:941–944
Ferrucci JJ, Eaton SB (1973) Radiology of the Pancreas. N Engl J Med 288:506–510
Fiegler W, Wegener OH, Hartmann K, Felix R (1980) Computertomographie und Sonographie. Vergleichsstudie bei Erkrankungen des Oberbauches und des Retroperitonealraumes. Fortschr Röntgenstr 132, 3:262–271
Foley WD, Stewart ET, Lawson TL, Geenan J, Loguidice J, Maher L, Unger GF (1980) Computed Tomography, Ultrasonography, and Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Disease: A comparative Study. Gastrointest Radiol 5:29–35
Frank KP, Linhart P, Hammes P (1982) Sonographische Befunde bei chronischer Pankreatitis. Klinikarzt 11:281–289
Freise J, Gebel M, Wellmann W, Huchzermeyer H (1981) Sonographie und endoskopische retrograde Pankreatikographie — Alternative oder komplementäre Untersuchungsverfahren in der Diagnostik der chronischen Pankreatitis und des Pankreascarcinoms? Ultraschall 2:65–69
Gmelin E, Weiss HD, Fuchs HD, Reiser M (1981) Vergleich der diagnostischen Treffsicherheit von Ultraschall, Computertomographie und ERCP bei der chronischen Pankreatitis und beim Pankreaskarzinom. Fortschr Röntgenstr 134, 2:136–141
Haaga JR, Alfidi RJ, Zelch MG, Meany TF, Boller M, Gonzalez L, Jelden GL (1976) Computed Tomography of the Pancreas. Radiology 120:589–595
Hessel SJ, Siegelman SS, McNeil BJ, Sanders R, Adams DF, Alderson PO, Finberg HJ, Abrams HL (1982) A Prospective Evaluation of Computed Tomography and Ultrasound of the Pancreas. Radiology 143:129–133
Huck L, Knop P, Hausamen TU (1981) „Sonographische Pankreasdiagnosc bei unklaren Oberbauchbeschwerden. Dtsch Med Wochenschr 106, 3:71–76
Husband JE, Meire HB, Kreel L (1977) Comparison of ultrasound and computer-assisted tomography in pancreatic diagnosis. Br J Radiol 50:855–863
Irnberger Th (1980) Wertigkeit und Leistungsgrenzen der Computertomographie in der Pankreasdiagnostik. Wien Med Wochenschr 2:96–100
Kressel HY, Margulis AR, Gooding GW, Filly RA, Moss AA, Korobkin M (1978) CT Scanning and Ultrasound in the Evaluation of Pancreatic Pseudocysts: A Preliminary Comparison. Radiology 126:153–157
Kuhn FP, Günther R, Ruckert K, Beyer J (1982) Ultrasonic Demonstration of Small Pancreatic Islet Cell Tumors. J Clin Ultrasound 10:173–175
Lackner K, Fromhold H, Grauthoff H, Mödder U, Heuser L, Braun G, Buurman R, Scherer K (1980) Wertigkeit der Computertomographie und der Sonographie innerhalb der Pankreasdiagnostik. Fortschr Rötngenstr 132, 5:509–513
Lammer J, Lepuschütz H, Sager WD, Kratochvil P, Brandstätter G, Zalaudek G (1980) ERCP und CT in der Diagnostik von chronischer Pankreatitis, Pseudozysten und Pankreaskarzinom — ein Vergleich. Röntgen-Bl 33:602–611
Lawson TL (1978) Sensitivity of Pancreatic Ultrasonography in the Detection of Pancreatic Disease. RAdiology 128:733–736
Lee JK, Stanley RJ, Melson GL, Sagel SS (1979) Pancreatic Imaging by Ultrasound and Computed Tomography. Radiol Clin N Am 16, 1:105–117
Levitt RG, Geisse GG, Sagel SS, Stanley RS, Evens RG, Koehler RE, Jost RG (1978) Complementary Use of Ultrasound and Computed Tomography in Studies of the Pancreas and Kidney. Radiology 126:149–152
Liguory G, Caletti (1976) An Evaluation of Endoscopic Retrograde Pancreatography (ERCP) in Chronic and Relapsing Acute Pancreatitis. Endoscopy 8:59–64
Lutz H, Petzoldt R, Hofmann KP, Rösch W (1975) Ultraschalldiagnostik bei Pankreaserkrankungen im Vergleich zur endoskopisch retrograden Pankreasgangdarstellung. Klin Wochenschr 53:419–424
Lutz H (1978) Ultraschalldiagnostik (B-Scan) in der Inneren Medizin. Springer, Berlin Heidelberg New York
Mackie CR, Cooper MJ, Lewis MH, Moossa AR (1979) Non-operative Differentiation between Pancreatic Cancer and Chronic Pancreatitis. Ann Surg 189, 4:480–487
McCullough EC, Payne JT (1978) Patient Dosage in Computed Tomography. Radiology 129:457–463
Moss AA, Federle M, Shapiro HA, Ohto M, Goldberg H, Korobkin M, Clemett A (1980) The Combined Use of Computed Tomography and Endoscopic Retrograde Cholangiopancreatography in the Assessment of Suspected Pancreatic Neoplasm: A Blind Clinical Evaluation. Radiology 134:159–163
Haaga JR (1979) Computed tomography of the abdomenen. Mosby, Philadelphia
Computer-Tomographie in der Diagnostik innerer Erkrankungen (1980) Sitzungsbericht des ärztlichen Vereins Hamburg. Muench Med Wochenschr 122, 26:949–986
Pochhammer KF, Székessy T (1982) Sonographie und Pankreaslänge. Ultraschall 3:2–3
Pollock D, Taylor KJW (1982) Ultrasound Scanning in Patients with Clinical Suspicion of Pancreatic Cancer: A Retrospective Study. Cancer 47:1662–1665
Rettenmaier G (1976) Sonografischer Oberbauchstatus. Internist 17:549–564
Robbins AH, Messian RA, Widrich WC, Paul RE, Nortin RA, Schimmel EM, Ogoshi K (1974) Endoscopic Pancreatography: An Analysis of the Radiologic Findings in Pancreatitis. Radiology 113:293–296
Rohrmann CA, Silvis SE, Vennes JA (1974) Evaluation of the Endoscopic Pancreatogram. Radiology 113:297–304
Sauerbruch T, Wotzka R, Rehkamp D, Rummel Th (1979) Oberbauchsonographie und ERCP. Dtsch Med Wochenschr 104:165–171
Silvis SE, Rohrmann CA, Vennes JA (1973) Diagnostic criteria for the evaluation of the endoscopic pancreatogram. Gastrointest Endoscopy, vol 20, 2:51–55
Schneekloth G, Frank T, Albers G (1977) Ultraschalltomographie abdomineller Organe und der Schilddrüse im Grey-Scale-Bild. Enke, Stuttgart
Schoppe WD, Jungblut RM (1982) Stellenwert der Computertomographie in der Diagnostik gastrointestinaler Erkrankungen. Z Gastroenterol 20, 9:9–28
Struve C (1980) Pankreaspseudozysten. Verlauf und therapeutische Konsequenzen. Med Welt 31, 33:1171–1173
Struve C (1980) Ultraschalltomographie des Abdomens. Urban & Schwarzenberg, München Wien Baltimore
Kazuei Ogoshi (1979) Diseases of the Pancreas and the Biliary System. In: Tadayoshi et al. (eds) Endoscopic retrograde Cholangiopancreaticography. Igaku, Shoin Tokio New York
Taylor KJ, Buchin PJ, Viscomi GN, Rosenfield AT (1981) Ultrasonographic Scanning of the Pancreas. Radiology 138:211–213
Triller J, Fischedick AR, Haertel M, Halter F, Scheuerer U (1980) Sonographie und endoskopisch retrograde Cholangio-Pankreatikographie zur Diagnostik von Pankreas- und Gallenwegserkrankungen. Fortschr Röntgenstr 132 3:255–261
Triller J, Fuchs WA (1980) Abdominale Sonographie. Thieme, Stuttgart New Xork
Weill FS (1982) Ultraschalldiagnostik in der Gastroenterologie. Springer, Berlin Heidelberg New York
Wiggans G, MacDonald JS, Schein PS, Schellinger D, Harbert J (1976) Computerised Axial Tomography for Diagnosis of Pancreatic Cancer. Lancet II:233–235
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Swobodnik, W., Meyer, W., Brecht-Kraus, D. et al. Ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the morphologic diagnosis of pancreatic disease. Klin Wochenschr 61, 291–296 (1983). https://doi.org/10.1007/BF01497778
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DOI: https://doi.org/10.1007/BF01497778