[Comparison of color Doppler ultrasonography and endoscopic ultrasonography for preoperative evaluation of the mesenteric-portal axis in pancreatic lesions].
OBJECTIVE
This prospective study was undertaken to evaluate the accuracy of ultrasonography combined with colour Doppler and endoscopic ultrasonography for predicting superior mesenteric and portal vein involvement in pancreatic diseases.


METHODS
The study was prospective. Forty-four patients were included. Ultrasonography with colour Doppler was performed in 30 patients, endoscopic ultrasonography in 43. Prediction of superior mesenteric vein or portal vein involvement was blindly assessed by physicians without knowledge of results of other imaging methods. Resectability or potential resectability (n = 34) and irresectability (n = 10) were assessed in all patients by surgery. Thirty patients underwent a pancreaticoduodenectomy.


RESULTS
For endoscopic ultrasonography the sensitivity (0.90), the specificity (0.88), the positive predictive value (0.69) and the negative predictive value (0.97) were better than those observed with ultrasonography and Doppler (050, 0.88, 0.69, 0.97, respectively). The specificity of computed tomography (0.96) was better than that of endoscopic ultrasonography but predictive negative values were similar.


CONCLUSIONS
Imaging methods to predict superior mesenteric or portal vein involvement in pancreatic diseases are becoming increasingly numerous, complex, and expensive. Endoscopic ultrasonography has a better diagnostic value for correctly predicting resectability than ultrasonography with Doppler. However, for decision making, usefulness of these methods seems to be limited.
Baarir
N
N
Service de chirurgie digestive, hôpital Tenon, Paris, France.
Amouyal
G
G
Faintuch
J M
JM
Houry
S
S
Huguier
M
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D014670:Ampulla of Vater / Q000000981:diagnostic imaging; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D002908:Chronic Disease; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D004724:Endoscopy; D005069:Evaluation Studies as Topic; D005544:Forecasting; D006801:Humans; D008642:Mesenteric Veins / Q000000981:diagnostic imaging*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000601:surgery; D011169:Portal Vein / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional