الفهرس 
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Abstract
CT angiography proved to be an important tool in assessing intra abdominal malignancy specially the cancer of the pancreas which in most of cases is missed by abdominal ultrasonography due to many factors as obesity and masculine people, gaseous distension, fatty pancreas and pancreatic atrophy, MDCT has many advantages that are related to its rapid scanning and consequently imaging of the dye inside the vessels either arteries or veins before tissue perfusion, together with the capability of reconstruction and reformatting gave the advantages of vascular mapping and consequently its relation to the surrounding organs and tumours when present and thus assessing its infiltration, encasement or displacement which is very important in staging of the tumour.
Cancer of the pancreas is a very aggressive malignancy that caries a very poor prognosis and it is frequently inoperable when 1st diagnosis and the peri-pancreatic vessels are frequently invaded by the tumour that mostly makes its resectability is impossible, so CT angiography should be done to all cases before beginning the treatment, MDCT also helps assessing other factors as local invasion of surrounding tissues, local lymphadenopathy and the presence or absence of distant metastasis.
the frequency of venous invasion by pancreatic tumours is significantly higher than arteries, and despite the similarity in the MDCT signs of vascular invasion between arteries and veins, they are seen significantly more in veins than arteries. It is important to pay attention to those differences in order to improve the accuracy of diagnosing vascular invasion and tumour resectability, In the absence of obvious liver metastases or local tumor extension, tumor resectability will depend on the presence of vascular involvement.
Recommendations:
MCT and CT angiography should be done in any suspected case of pancreatic cancer , where complete staging with ultrasound is not possible. so MDCT and CTA should be used to map the vascular anatomy and determine the extent of the disease before considering surgery.
Laparoscopic staging using laparoscopic ultrasound are essential and recommended to be done in the operable stages of the disease.