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American Journal of Roentgenology, Vol 172, 615-618, Copyright © 1999 by American Roentgen Ray Society

ARTICLES

Assessment of pancreatic invasion in patients with advanced gastric carcinoma: usefulness of the sliding sign on sonograms

HK Lim, S Kim, JH Lim, SH Kim, WJ Lee, H Chun, JW Cho and JJ Kim
Department of Radiology, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea.

OBJECTIVE: The purpose of our study was to determine the value of the sliding sign on sonograms in evaluating direct pancreatic invasion of advanced gastric carcinoma. SUBJECTS AND METHODS: Sonography was performed prospectively on 70 patients with pathologically proven advanced gastric carcinoma. Sonography was directed at the detection of motion between the gastric mass and the pancreas. When the gastric mass showed complete sliding motion against the pancreas or partial sliding motion with a preserved echogenic fat plane between the two organs on respiration or on extrinsic compression with a transducer (positive sliding sign), patients were considered to have no pancreatic invasion. When the gastric mass had no sliding motion against the pancreas or partial sliding motion with a disrupted echogenic fat plane between the two organs (negative sliding sign), patients were considered to have pancreatic invasion. After sonography, all patients underwent surgery and the results of sonography were compared with the findings at surgery and pathology. RESULTS: Of the 70 patients, 17 had pancreatic invasion and 53 had no evidence of pancreatic invasion at surgery and pathology. The sliding sign on sonography yielded an 80% sensitivity, 96% specificity, and 90% accuracy for the diagnosis of pancreatic invasion. CONCLUSION: Application of the sliding sign on sonography was simple and highly accurate in the diagnosis of pancreatic invasion by advanced gastric carcinoma. The sliding sign may prove useful in the preoperative detection of pancreatic invasion by gastric carcinoma when CT has been inconclusive.
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