Chen Chien-Hua, Yang Chi-Chieh, Yeh Yung-Hsiang, Huang Min-Ho
Division of Gastroenterology, Department of Internal Medicine, Show-Chwan Memorial Hospital, 542, Section 1, Chung-Shang Road, Changhua 500, Taiwan.
J Clin Ultrasound. 2004 May;32(4):179-85. doi: 10.1002/jcu.20018.
The purpose of this prospective study was to utilize contrast-enhanced power Doppler sonography to evaluate the enhancement characteristics of ductal pancreatic adenocarcinomas and correlate them with the tumor vascularity observed on digital subtraction angiography (DSA).
Twenty consecutive patients with ductal pancreatic adenocarcinoma underwent power Doppler sonography and DSA. Tumor vascularity was assessed using unenhanced and contrast-enhanced power Doppler sonography. The contrast agent Levovist was administered intravenously by bolus injection of a dose of 2.5 g at a concentration of 350 mg/mL; saline was administered immediately thereafter. The patients were asked to hold their breath for 30 seconds (for the period 15-45 seconds after saline injection) while the early phase of enhancement was studied; the delayed phase of enhancement was observed between 60 and 120 seconds after saline administration, while patients breathed gently.
None of the 20 pancreatic carcinomas showed any color signals on power Doppler sonography before administration of the contrast medium. Seventeen (85%) of the 20 pancreatic carcinomas also showed no enhancement in the early and delayed phases of contrast-enhanced power Doppler sonography. However, in the early phase of contrast-enhanced power Doppler sonography; 1 lesion showed pronounced enhancement and 2 showed mild enhancement. On DSA, the 17 carcinomas showing no enhancement on power Doppler sonography were found to be hypovascular, whereas the remaining 3 carcinomas with contrast enhancement on power Doppler sonography were found to be hypervascular.
The enhancement characteristics of the ductal pancreatic adenocarcinomas correlated well with the tumor vascularity observed on DSA. However, further study is needed to determine the accuracy of contrast-enhanced sonography in the diagnosis of pancreatic masses.
本前瞻性研究旨在利用对比增强功率多普勒超声评估胰腺导管腺癌的增强特征，并将其与数字减影血管造影（DSA）观察到的肿瘤血管情况相关联。
连续20例胰腺导管腺癌患者接受了功率多普勒超声和DSA检查。使用未增强及对比增强功率多普勒超声评估肿瘤血管情况。通过静脉团注给予造影剂声诺维，剂量为2.5 g，浓度为350 mg/mL；随后立即给予生理盐水。在研究增强早期时，要求患者屏气30秒（在注射生理盐水后15 - 45秒期间）；在注射生理盐水后60至120秒之间观察增强延迟期，此时患者轻轻呼吸。
20例胰腺癌在给予造影剂前，功率多普勒超声均未显示任何彩色信号。20例胰腺癌中有17例（85%）在对比增强功率多普勒超声的早期和延迟期也未显示增强。然而，在对比增强功率多普勒超声的早期，1个病灶显示明显增强，2个病灶显示轻度增强。在DSA上，功率多普勒超声未显示增强的17例癌灶被发现为低血供，而其余3例在功率多普勒超声上有对比增强的癌灶被发现为高血供。
胰腺导管腺癌 的增强特征与DSA观察到的肿瘤血管情况密切相关。然而，需要进一步研究以确定对比增强超声在胰腺肿块诊断中的准确性。
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