3-DIMENSIONAL INTRADUCTAL ULTRASONOGRAPHY - PRELIMINARY-RESULTS OF A NEW TECHNIQUE FOR THE DIAGNOSIS OF DISEASES OF THE PANCREATICOBILIARY SYSTEM

Background and Study Aims: Intraductal ultrasonography (IDUS) is a use ful method for the diagnosis of pancreatobiliary diseases, but the ima ges obtained using the presently available ultrasonic probes are limit ed by their two-dimensional nature and are sometimes difficult to inte rpret, The possible application of three-dimensional intraductal ultra sonography (3 D-IDUS) to facilitate the diagnosis of pancreatobiliary disease was therefore studied using a newly developed system, Patients and Methods: 3 D-IDUS of the biliary system was performed on 26 patie nts with benign (n=10) or malignant pancreatobiliary diseases (n=16), via percutaneous transhepatic or peroral approaches, Three-dimensional diagnoses were made using both radial and linear images generated on the monitor of this system along with a comparison with conventional I DUS (2 D-IDUS) findings, Results: The courses of vessels surrounding t he bile duct could be easily imaged in all cases, and accurate assessm ent of tumor extension and the relationship with surrounding organs co uld be achieved for all the malignancies, In four of six cases of bile duct cancers the whole outline of the tumor could be visualized so th at the tumor volumes could be measured, Conclusions: These preliminary results of 3 D-IDUS in the pancreatobiliary system, the first to be r eported in the English literature, indicate that this new system has c lear advantages over the 2 D-IDUS approach for diagnostic purposes, Fu rther technical improvements can be expected which will ensure a clini cal role for 3 D-IDUS.