الفهرس 
· Anatomy of the pancreasOnly 14 pages are availabe for public view
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Abstract
Pancreatic cancer is the fourth leading cause of death among both men and women. Over 90% of the patients with pancreatic carcinoma die within 1 year of diagnosis. Tumor stage, microscopic grade and tumor size represent the factors that determine the prognosis of pancreatic tumors. Small tumors have the greatest chance of curative operation and the longest survival. The pancreatic cancer is not hindered by anatomical borders and therefore rapidly involves the extra pancreatic tissues. Surgical resection is the only curative measure for pancreatic cancer. It depends on early diagnosis before peripancreatic vascular invasion. The introduction of multislice CT with three dimensional postprocessing imaging techniques allows accurate imaging of the pancreas and peripancreatic structures that displays the anatomy and disease entity in an orientation that simulates a direct surgical approach. Multislice computerized tomography allows examination of the pancreas with thin slice thickness (1mm) or less during a short time of a single breath hold with high quality images. This allows application of different pancreatic scanning Protocols, the best of which is three phase protocol. The arterial phase is helpful for detection of hypervascular tumors, and obtaining CT angiography of peripancreatic vasculature to determine vascular involvement. The parenchymatous and portal venous phases are important for detection of hypovascular tumors that represent nearly all pancreatic carcinoma, and for detection of liver metastasis. 90% of pancreatic adenocarcinoma are unresectable. MSCT is useful to prevent an unnecessary Whipple procedure (resection of the distal stomach, duodenum, and part or all of the pancreas). Any of the following findings are CT signs of unresectability: liver metastases, ascites, local extension (except duodenum), arterial encasement, venous occlusion, and lymph node enlargement outside the field To conclude, contrast-enhanced multiphase pancreatic imaging by multislice computerized tomography (MSCT) with its postprocessing techniques represents the image of choice for diagnosis and local staging of pancreatic tumors.