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Abstract
Purpose:
To classify perivascular change in the celiac trunk ana SMA occurring in pancreatic disease and to evaluate its significance in differential diagnosis.
Materials and Methods:
In 73 patients with pancreatic disease (42, acute pancreatitis å 14, chronic pancreatitis; 17, panreatic cancer) abdominal CT findings were retrospectively reviewed. We defined infiltration as linear or irregular density and thickeningô’ as presence of a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors for the differential diagnosis of pancreatic diseases.
Results:
In 13/42 cases of acute pancreatitis (31%), 4/l4 of chronic pancreatitis (28.6%), and 6/l7 of pancreatic cancer (35.3%), periceliac infiltration was observed å the frequencies were not statistically significant (p=0.916). Peri-SMA infiltration was demonstrated in 9/42 of acute pancreatitis 4%), 4/14 of chronic pancreatitis (28.6%), and 5/l7 of pancreatic cancer (29.4%);again, these frequencies were not statistically significant (p=0.758). Thickening of the celiac trunk and SMA was observed only in pancreatic cancer, in 3/l7 (17.6%) and 7/17(41.2%) cases, respectively, with statistical significance (P〈0.05).
Conclusion:
Thickening of the celiac trunk and SMA is a valuable flndinp in the differential diagnosis of pancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreatic disease, perivascular change should be classified as either infiltration or thickening.
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 | Fig. 1.A. Reticular infiltration of perivascular fat is demonstrated at SMA root in chronic pancreatitis 8. Perivascular fat infiltration is shown at celiac root in acute pancreatitis. |
 | Fig. 2.Sixty-three year old male patient with pancreatic carcinoma å irregular infiltration is noted at SMA root area. |
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