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Pancreas: Does Hyoscyamine Butylbromide Increase the Diagnostic Value of Helical CT?

Andrik J. Aschoff, MD1, Johannes Görich, MD1, Roman Sokiranski, MD1, Andrea Rieber, MD1, Hans-Jürgen Brambs, MD1 and Stefan C. Krämer, MD1

1 Department of Diagnostic Radiology, University of Ulm, Steinhövelstr 9, D 89075 Ulm, Germany.



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  		Figure 1a. Contrast material–enhanced helical CT studies with hyoscyamine butylbromide in a 59-year-old man with carcinoma of the pancreas. (a) Arterial phase scan shows excellent distention of the stomach (S) (rated 5), well-dilated proximal duodenum (arrows) (rated 4.33), and almost no motion artifacts. (b) Arterial phase scan shows a hypoattenuating pancreatic mass (m) adjacent to the sharply delineated duodenal wall (arrows) (rated 3.67), good distention of the distal duodenum (rated 4.33), and excellent contrast enhancement of the superior mesenteric artery (a) (rated 5) and splenic vein (v) (rated 4.33).

 


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  		Figure 1b. Contrast material–enhanced helical CT studies with hyoscyamine butylbromide in a 59-year-old man with carcinoma of the pancreas. (a) Arterial phase scan shows excellent distention of the stomach (S) (rated 5), well-dilated proximal duodenum (arrows) (rated 4.33), and almost no motion artifacts. (b) Arterial phase scan shows a hypoattenuating pancreatic mass (m) adjacent to the sharply delineated duodenal wall (arrows) (rated 3.67), good distention of the distal duodenum (rated 4.33), and excellent contrast enhancement of the superior mesenteric artery (a) (rated 5) and splenic vein (v) (rated 4.33).

 


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  		Figure 2a. Contrast-enhanced helical CT studies without hyoscyamine butylbromide in a 61-year-old man with an insulinoma. (a) Arterial phase scan shows excellent enhancement of the pancreatic tumor (arrows) and very good duodenal distention (d) and delineation of the head of the pancreas (both rated 4.67). A cyst is in the right kidney. (b) On the portal venous scan, the insulinoma vanished while image quality remains excellent. No motion artifacts are seen.

 


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  		Figure 2b. Contrast-enhanced helical CT studies without hyoscyamine butylbromide in a 61-year-old man with an insulinoma. (a) Arterial phase scan shows excellent enhancement of the pancreatic tumor (arrows) and very good duodenal distention (d) and delineation of the head of the pancreas (both rated 4.67). A cyst is in the right kidney. (b) On the portal venous scan, the insulinoma vanished while image quality remains excellent. No motion artifacts are seen.

 




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