Intraportal endovascular ultrasonography as a new diagnostic procedure in pancreatic surgery.
OBJECTIVE
This presents the results of a prospective study on the use of intraportal endovascular ultrasonography (IPEUS) as a screening tool for pancreatic carcinoma.


METHODS
Twenty-four patients with pancreatic cancer (17 head, 7 body) were studied for portal vein invasion using intraportal endovascular ultrasonography (IPEUS). In 22 cases, IPEUS was performed intraoperatively from the superior mesenteric venous route with an 8-French, 20 MHz intravascular ultrasound (IVUS) catheter, in two cases preoperatively from the percutaneous transhepatic route with a 6- French, 20 MHz IVUS catheter. The sonographic criterion for detection of portal venous invasion was obliteration of the echogenic band of the portal vein. The IPEUS results were compared with those of CT and portography.


RESULTS
Vascular invasion was confirmed with resected specimens in nine cases and with operative findings in three patients. For diagnosis of portal venous invasion, the sensitivity, specificity, and overall accuracy of IPEUS were 100%, 91.7%, and 95.8% respectively. For portography, the equivalent values were 66.7%, 75%, and 70.8%, while those for CT were 75%, 66.7%, and 70.8%.
Kaneko
T
T
Department of Surgery II, Faculty of Medicine, Nagoya University, Japan.
Nakao
A
A
Inoue
S
S
Nomoto
S
S
Hosono
J
J
Harada
A
A
Nonami
T
T
Takagi
H
H
D000368:Aged; D005260:Female; D006801:Humans; D007432:Intraoperative Period / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods*