Characteristic pancreatographic findings in chronic pancreatitis and their diagnostic value. …Studies on post mortem pancreas…

慢性膵炎25例および対照として正常例125例計150例の新鮮剖検膵を用いて膵管造影を行い，X線所見と同部位の組織所見とを厳密に対比させ，慢性膵炎における各X線所見の診断学的価値を検討した。その結果，主膵管像では不整拡張像，硬化＋辺縁不整像，狭窄＋辺縁不整像が，分枝像では不整拡張像および不整配列像が，positive predictive value（PPV），specificity（Sf），negative predictive value（NVP）ともに77.1～100％ の高率を示した。しかしsensitivity（St）は，2.1～18.1％ と低率であった。したがって，これらの所見は慢性膵炎を診断する上で組織予見性および特異性に優れた診断的価値のあるX線所見と言える。しかし一方では軽症の慢性膵炎の検出能はあまりよくないという限界が膵管造影法にはある。Postmortem pancreas tissue was prepared within 6 hours of death for the comparative study of pancreatographic findings and histological findings to define characteristic pancreatographic findings of chronic pancreatitis and determine their diagnostic value. Pancreas tissue was obtained from 25 patients with chronic pancreatitis and 125 with a normal pancreas. Among various pancreatographic findings, irregular dilatation and irregular arrangement of the branches of the pancreatic duct, and also irregular dilatation, rigidity with irregular margin and stenosis with irregular margin of the main pancreatic duct showed the highest sensitivity. specificity, positive predictive value and negative predictive value and conseqently had the highest diagnostic valus. However, the sensitivity was not high enough, indicating that the above pancreatographic findings could be absent at the site of positive histological findings in mild chronic pancreatitis