COLOR DOPPLER IMAGING IN THE ASSESSMENT OF VASCULAR INVOLVEMENT BY PANCREATIC-CARCINOMA

OBJECTIVE. The aim of our study was to assess the accuracy of color Do ppler imaging in diagnosing the involvement of peripancreatic vessels by pancreatic carcinoma. SUBJECTS AND METHODS. We prospectively evalua ted the color Doppler images of 61 patients with pancreatic carcinoma. Our evaluations occurred before surgery and focused on vascular invol vement. Absence of contact or a short contiguity (less than or equal t o 2 cm) between tumors and peripancreatic vessels was considered to be a sign of resectability on color Doppler imaging; a long contiguity ( >2 cm), compression, encasement, or thrombosis was considered to be a sign of unresectability. In all patients, the sonographic diagnosis wa s compared with the surgical results. RESULTS. With color Doppler imag ing, we detected signs of vascular involvement in 26 of 33 patients in whom vascular involvement was found at surgery. We detected no vascul ar involvement in 25 of 28 patients in whom no vascular involvement wa s found at surgery. No false-positive diagnoses occurred when vascular encasement was revealed by color Doppler imaging. For diagnosis of va scular involvement, the sensitivity, specificity, and overall accuracy of color Doppler imaging were 79%, 89%, and 84%, respectively; positi ve and negative predictive values were 89% and 79%, respectively. CONC LUSION. Color Doppler imaging is a sensitive and highly specific techn ique in assessing vascular involvement by pancreatic cancer when absen ce of contact or vascular encasement is seen. When vascular encasement is detected by color Doppler imaging, a definitive diagnosis of unres ectability can be made, and further diagnostic procedures can be avoid ed. When sonography is used in the initial evaluation of pancreatic ca ncer, color Doppler imaging can improve the selection of patients for further diagnostic examinations or surgical exploration.