Abstract
In order to investigate diagnostic values of the pancreatogram in chronic pancreatitis, micropancreatographies and their histological analyses were performed on 75 necropsy specimens, including 17 cases of chronic pancreatitis, 22 cases of pancreatic fibrosis, 5 cases of pancreatic fibrosis with focal pancreatitis, 9 cases of carcinomatous lesion of pancreas and 22 cases of normal pancreas.
The histological changes of the pancreatic ducts were closely related to those of the parenchyma, and hyperplasia and metaplasia of the ductal epithelium were observed in a high incidence in chronic pancreatitis.
The irregular and rigid outline of the main duct observed radiologically in 15 cases of chronic pancreatitis, was closely related to ductal hyperplasia. Dilatation or narrowing with irregular and rigid outline were frequently observed in chronic pancreatitis, although 5 cases of chronic pancreatitis (30% of total) showed no dilatation or narrowing. Severe degree of narrowing of the main duct was seen in the pancreatogram of both chronic pancreatitis and carcinomatous lesion. However, radiological obstruction of the main duct was the characteristic finding in carcinomatous lesion.
The relations between the radiological findings of the branches of the pancreatic ducts and their pathological changes were also studied. In chronic pancreatitis, decreases in the numbers of the small branches and cystic dilatations of the branches due to fibrosis, or ductal hyperplasia and metaplasia were frequently observed.
