Ueno N, Tomiyama T, Tano S, Wada S, Miyata T
Department of Gastroenterology, Jichi Medical School, Tochigi, Japan.
J Ultrasound Med. 1997 Dec;16(12):825-30. doi: 10.7863/jum.1997.16.12.825.
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.
我们回顾性评估了彩色多普勒超声对21例接受手术探查的胰腺癌患者门静脉侵犯的诊断价值（14例行切除术，7例行探查术）。对所有患者均进行了实时灰阶超声、彩色多普勒超声、计算机断层扫描和血管造影以评估门静脉侵犯情况，并将图像与组织病理学或手术探查结果进行比较。在比较灰阶超声图像和彩色多普勒超声图像时，63支血管中有14支（22.2%）在彩色多普勒超声上显示的肿瘤与血管的关系比灰阶超声更清晰。彩色多普勒超声、计算机断层扫描和血管造影诊断门静脉侵犯的敏感性分别为73.7%、73.7%和73.6%，特异性分别为95.1%、95.5%和90.9%；总体准确率分别为84.1%、88.9%和85.7%。在12支血管中观察到镶嵌信号模式，其诊断门静脉侵犯的准确率为86.4%。总之，与灰阶超声相比，彩色多普勒超声能更好地显示肿瘤和门静脉的图像。此外，彩色多普勒超声评估门静脉侵犯的准确率似乎与计算机断层扫描和血管造影相当。因此，彩色多普勒超声可能作为评估门静脉侵犯的初始检查发挥重要作用。
