COLOR DOPPLER ULTRASONOGRAPHY IN THE DIAGNOSIS OF PORTAL-VEIN INVASION IN PATIENTS WITH PANCREATIC-CANCER

We retrospectively evaluated the diagnostic usefulness of color Dopple r ultrasonography for detecting portal vein invasion in 21 patients wi th pancreatic cancer who underwent surgical exploration (14 resection, seven inspection). Real-time gray scale ultrasonography, color Dopple r 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 ultr asonographic images, the tumor-vessel relations were visualized more c learly on color Doppler ultrasonography than on gray scale ultrasonogr aphy in 14 (22.2%) of 63 vessels. The sensitivity of color Doppler ult rasonography, computed tomography, and angiography for diagnosing port al 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 inv asion. In conclusion, compared with gray scale ultrasonography, color Doppler ultrasonography provided improved images of the tumor and port al vein. Furthermore, the accuracy of color Doppler evaluation of port al vein invasion appears to be equal to that of computed tomography an d angiography. Therefore, color Doppler ultrasonography may play an im portant role as an initial examination for evaluating portal vein inva sion.