Objective. To evaluate the respective value of dual-phase helical CT arterial portography (CTAP) and conventional angiography in preoperative predicting resectability of pancreatic ductal adenocarcinoma. Subjects and methods. Tumor resectability was prospectively evaluated in 54 patients with pathologically proven pancreatic ductal adenocarcinoma who later underwent surgery. Both dual-phase helical CT scanning and selective angiography were obtained in each patient preoperatively. For optimal enhancement of pancreas and major peripancreatic vessels, two catheters connected to an automatic injector via a Y-shaped tube were placed after selective angiography,one in celiac trunk, the other in superior mesenteric artery. Then the patient underwent dual-phase helical CTAP of pancreas and liver. The criteria of irresectability for CTAP include: tumor diameter≥ 5 cm,extrapancreatic invasion, distant metastases and vascular involvement(occlusion, stenosis or semicircular encasement of superior mesenteric artery, hepatic artery, splenic artery, celiac axis; portal vein, superior mesenteric vein or splenic vein). The results of both modalities were correlated with findings from surgery or pathology. Results. Thirty-eight of 54 patients had nonresectable disease. In prediction the irresectability, sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were 94.7％ ,100％ ,100％ ,88.9％ ,96.3％ respectively for helical CTAP and 63.2％ ,93.8％ ,96.0％ ,51.7％ ,72.2％ respectively for selective angiography. In assessing vascular involvements, dual-phase helical CTAP was also superior to selective angiography. Conclusion. Dual-phase helical CTAP is superior to angiography in assessing resectability of pancreatic ductal adenocarcinoma. The combination of the two modalities may further improve overall accuracy of assessment.

Objective To study the endovascular treatment of artery rupture caused by injury on which surgery was impossibly performed. Methods All 76 patients underwent selective angiography to make accurate diagnosis. Endovascular occlusion of the target artery with a balloon catheter was accomplished and surgical vessel repair followed in 13 cases. Under the condition that the blood supply of the remote limb on which the artery rupture was detected remained normal, the injured artery was obstructed completely with either detachable balloon or coil in 63 cases.Results No complication, disability, or death was found in any case.Conclusions Occlusion of the blood flow of the target vessel with balloon catheter is an easy, effective and safe preoperational approach for patients who fail to be treated perfectly with direct surgery.