Modern approaches to X-ray diagnostics of neoplasms of the periampular zone of duodenum

Among malignant neoplasms of the gastrointestinal tract, periampular tumors are among the leaders in mortality among cancer patients. The most pressing issue is differential diagnosis of chronic inflammatory and neoplastic processes, early detection of the tumor, thorough pre-operative staging according to TNM classification with determination of resectability, prediction and detection of early and late postoperative complications, progression and recurrence of the tumor process, as well as evaluation of its effectiveness in combined treatment. To a greater extent, this is due to the complexity of visualization of the PAZ region due to the large concentration of anatomical elements on a small area, the similarity of radiation semiotics and the difficulties of differential diagnosis of pseudo-tumor inflammatory diseases, benign and malignant neoplasms, difficulties in assessing the local spread of the process, in particular, the detection of extrapancreatic perineural tumor invasion, invasion of visceral vessels, complexities To diagnose PZ formations, various methods are used, from the most common and successful to prove themselves time (CT, MRI transabdominal ultrasound, laboratory methods), to more specialized ones aimed at more accurate diagnostics (endoultrasonography (ETG), ERCHPG, scintigraphy, PET.) Nevertheless, the issues of differential diagnosis of pancreas cancer and pseudotumorrhotic pancreatitis, the detection of isodense and isovascular tumors, which account for about a fifth of all neoplasms, remain extremely complex.