In-Vivo ¹H Magnet-Resonanz-Spektroskopie der Gallenblasenflüssigkeit als Nachweis des Pankreaskarzinoms

Abstract

Pre-, intra- and even sometimes postoperative differentiation of the entity of various tumors of the pancreato-biliary system remains unsatisfactory. Own results showed that the quantification of tumor markers in gallbladder bile is superior to any other established method for detecting pancreato-biliary malignancies. In order to gain information on gallbladder bile content we established a non-invasive method to examine bile concentrations preoperatively. In a prospective study 20 healthy subjects and 32 patients suffering from tumor of the head of the pancreas were examined by in vivo ¹H-magnetic resonance spectroscopy of gallbladder bile. Surgery was performed in every patient examined, revealing a total of 18 carcinomas and 14 tumors due to chronic pancreatitis, ¹H-magnetic resonance spectroscopy revealed 11 different peaks representing different resonances. Significant differences were found in the comparison of probands and patients suffering from carcinoma for aliphatic methyl groups of lipids and for total lipid amount. Comparison of patients suffering from carcinoma and benign tumors of the pancreas vs. probands revealed a significant difference in the resonance of choline. Phosphomonoester resonance showed significant differences in the comparison of probands and patients suffering from pancreatitis. This study introduces a non-invasive chemical analysis of gallbladder bile for the differentiation of diseases of the pancreas. A clear discrimination of benign and malignant lesions of the pancreas could not be shown by in vivo ¹H-magnetic resonance spectroscopy, but the tendencies shown in results justify further study.