Diagnosis of Pancreatic Diseases by Scintigraphy

With 63 cases on whom we performed the scintigraphy of pancreatic diseases, we studied the possiblity of differential diagnosis and oter points relevant to the diagnosis in this disease group by comparing retrospectively clinical findings with postoperative findings of these cases, and arrived at the conclusions as follows: 1) For the scintigraphy of pancreas, scinticamera is excellent, and it is especially useful to take consecutive pictures at intervals of 10 minutes each for one hour with this camera after injecting (75)Se-methionine. 2) The major cases of the pancreas that gives normal visualization can be considered as normal, but as normal pictures can be obtained even in the cases of chronic pancreatitis. There are some cases where differential diagnosis between the two disease groups is difficult by scintigraphic finding. 3) In the case of a focal decrease of uptake first of all cancer can be suspected. However, there are cases where differentiation from chronic pancreatitis is difficult. In such instances, about half of the cases demonstrating roentgenologically calcification proves to be of chronic, calcified pancreatitis, but excluding these cases the percentage of cancer cases is high. 4) Among those cases showing pancreas in scintigram faint or nonvisible, there were two cases out of 3 where chronic pancreatitis was complicated with calcification. Excluding the two cases, cancer occupies a decidedly high percentage, and the cancer is mostly located around the head of pancreas, indicating that pathologic changes have invaded main pancreatic ducts. 5) There were 7 cases of chronic, calcified pancreatitis, one case giving normal pancreatitis, one case giving normal scitigraphic findings, 4 cases a focal decrease of uptake, and two cases showing the pancreas faint or nonvisible