Journal of Ultrasound in Medicine, Vol 16, Issue 12 825-830, Copyright © 1997 by American Institute of Ultrasound in Medicine
Color Doppler ultrasonography in the diagnosis of portal vein invasion in patients with pancreatic cancer
N. Ueno, T. Tomiyama, S. Tano, S. Wada and T. Miyata
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
We retrospectively evaluated the diagnostic usefulness of color Doppler
ultrasonography for detecting portal vein invasion in 21 patients with
pancreatic cancer who underwent surgical exploration (14 resection, seven
inspection). Real-time gray scale ultrasonography, color Doppler
ultrasonography, computed tomography, and angiography were performed in all
patients to evaluate portal vein invasion, and the images were compared
with the histopathologic or surgical inspection findings. On comparison
between gray scale ultrasonographic and color Doppler ultrasonographic
images, the tumor-vessel relations were visualized more clearly on color
Doppler ultrasonography than on gray scale ultrasonography in 14 (22.2%) of
63 vessels. The sensitivity of color Doppler ultrasonography, computed
tomography, and angiography for diagnosing portal invasion was 73.7%,
73.7%, and 73.6%, and the specificity was 95.1%, 95.5%, and 90.9%,
respectively; the overall accuracy was 84.1%, 88.9% and 85.7%,
respectively. A mosaic signal pattern was observed in 12 vessels and showed
an accuracy of 86.4% for diagnosing portal vein invasion. In conclusion,
compared with gray scale ultrasonography, color Doppler ultrasonography
provided improved images of the tumor and portal vein. Furthermore, the
accuracy of color Doppler evaluation of portal vein invasion appears to be
equal to that of computed tomography and angiography. Therefore, color
Doppler ultrasonography may play an important role as an initial
examination for evaluating portal vein invasion.
