Imaging-based evaluation and guidelines in the therapeutic behavior of pancreatic cystic lesions
А. Hilendarov, K. Velkova, G. Deenichin, B. Anavi
Abstract. Cystic pancreatic lesions are increasingly detected due to widespread of the diagnostic imaging methods. However, the therapeutic behavior has not standardized and continues to develop. Pursuit of this study is: by a combination of classification of pancreatic cystic lesions with clinical presentation of patients to arrive at an algorithm for diagnostic and therapeutic behavior. The study included 76 patsients (41 men and 35 women) undergone surgery with a definitive diagnosis of cystic pancreatic lesions. Ultrasonic and computer tomography machines were used for imaging investigations. Fine needle puncture and biopsies were performed under imaging control. In all 76 subjects included in the study were carried out at least two imaging survey methods. The most common diagnostic examination was ultrasound scan – 76 patients (100%). Computed tomography studies have been conducted in 61 (80,26% ) and magnetic resonance imaging in 15 (19,73%). More than half of patients surveyed have underwent some type of interventional procedure − FNA in 58 patients and FNAB in 49. Compared with the final results were evaluated specificity, sensitivity and accuracy of imaging methods were evaluated respectively: 72,22%, 87,93% and 84,21%. Algorithm for diagnostic and therapeutic behavior were proposed. By using the proposed algorithm, patients with mucinous tumors were detected and proper operative interventions would have been rendered with fewer diagnostic examinations.
Key words: pANCREATIC CYSTIC LESIONS. DIAGNOSTIC
INTERVENTIONAL pROCEDURES. FINE-NEEDLE ASpIRATION.