ASSESSMENT OF PORTAL-VEIN INVASION BY BILE-DUCT CANCER USING INTRADUCTAL ULTRASONOGRAPHY

被引:73
作者
TAMADA, K [1 ]
IDO, K [1 ]
UENO, N [1 ]
ICHIYAMA, M [1 ]
TOMIYAMA, T [1 ]
NISHIZONO, T [1 ]
WADA, S [1 ]
NODA, T [1 ]
TANO, S [1 ]
AIZAWA, T [1 ]
UENO, T [1 ]
KIMURA, K [1 ]
机构
[1] JICHI MED SCH,DEPT GASTROENTEROL,YAKUSHIJI,TOCHIGI 32904,JAPAN
关键词
D O I
10.1055/s-2007-1005760
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Study Aims: We recently reported on the contribution of intraductal ultrasonography (IDUS) to the regional staging of bile duct cancer, and we present here the first detailed study of the value of IDUS in assessing the portal vein invasion by bile duct cancer. Patients and Methods: Preoperative assessment of portal vein invasion was performed by IDUS via a percutaneous tract or via transpapillary route in 18 patients with extrahepatic bile duct cancer, Various probes, with diameters of 1,4, 2.0, 2.4, 2.6, and 3.2 mm, and frequencies of 7.5, 15, 20, and 30 MHz, were used. All patients additionally underwent endoscopic ultrasonography (EUS) and angiography. In the first six cases, the IDUS and EUS images were analyzed retrospectively without the knowledge of operative results or the other imaging tests. In the remaning 12 cases, IDUS and EUS images were prospectively reviewed prior to surgery, without knowledge of the angiographic findings. The gold standard for the results of IDUS, EUS and angiography was the histopathological findings in 17 resected tumors, and the intraoperative findings in one patient who did not undergo resective surgery. Results: IDUS was able to demonstrate the portal vein in all cases. Its accuracy in diagnosing portal vein invasion was 100% for all locations. EUS was useful in assessing portal vein invasion at the middle and distal bile duct (the accuracy was 91%), but was not useful in assessing invasion at the proximal bile duct (the accuracy was 57%). Conclusions: IDUS proved useful for assessing the extension of cancer invasion into the portal vein, even in proximal bile duct tumors.
引用
收藏
页码:573 / 578
页数:6
相关论文
共 19 条
[1]   INTRALUMINAL ULTRASONOGRAPHY DURING ERCP WITH HIGH-FREQUENCY ULTRASOUND CATHETERS [J].
CUSHING, GL ;
FITZGERALD, PJ ;
BOMMER, WJ ;
ANDREWS, MW ;
CRONAN, MS ;
MARTINEZTORRES, GG ;
JANG, YT ;
BELEF, WM ;
PRINDIVILLE, TP .
GASTROINTESTINAL ENDOSCOPY, 1993, 39 (03) :432-435
[2]   PREOPERATIVE STAGING OF A DISTAL COMMON BILE-DUCT TUMOR BY ENDOSCOPIC ULTRASOUND [J].
DANCYGIER, H ;
ROSCH, T ;
LORENZ, R ;
GOSSNER, W ;
SIEWERT, JR ;
CLASSEN, M .
GASTROENTEROLOGY, 1988, 95 (01) :219-222
[3]   ENDOLUMINAL ULTRASOUND OF THE BILE-DUCTS [J].
ENGSTROM, CF ;
WIECHEL, KL .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1990, 4 (04) :187-190
[4]  
FURUKAWA T, 1992, J ULTRAS MED, V11, P607
[5]  
Hermanek P., 1987, TNM CLASSIFICATION M, V4th ed.
[6]  
KUROIWA M, 1994, J ULTRAS MED, V13, P189
[7]   PERCUTANEOUS EXTRACTION OF BILIARY STONES - VALUE OF ENDOLUMINAL SONOGRAPHY [J].
LOSSEF, SV ;
GARRA, BS ;
BARTH, KH ;
ZEMAN, RK .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1992, 159 (02) :411-412
[8]   EVALUATION OF ENDOSCOPIC ULTRASONOGRAPHY IN THE PREOPERATIVE STAGING OF CARCINOMA OF THE AMPULLA OF VATER AND COMMON BILE-DUCT [J].
MUKAI, H ;
NAKAJIMA, M ;
YASUDA, K ;
MIZUNO, S ;
KAWAI, K .
GASTROINTESTINAL ENDOSCOPY, 1992, 38 (06) :676-683
[9]  
NAKAYAMA K, 1990, LIVER BILIARY TRACT, V21, P251
[10]  
ROBIN S, 1994, ANN SURG, V219, P267