ROLE OF COLOR DOPPLER ULTRASONOGRAPHY IN THE PREOPERATIVE STAGING OF PANCREATIC-CANCER

We describe our experience with color Doppler ultrasonography (CDU) in the preoperative staging of pancreatic cancer and, particularly, in d etecting the involvement of the portal-mesenteric trunk (PMT). Of the 54 patients studied, 43 (79.6%) underwent surgery and 11 (20.4%) did n ot because of evident infiltration of the PMT. Of the 43 patients oper ated on, the CDU study was normal in 8 cases (18.6%), abnormal in 33 ( 76.7%), and not possible in the remaining 2 cases (4.7%). Results of t he CDU were confirmed intraoperatively in 39 cases (diagnostic accurac y, 95.1%). In only two cases (4.9%) did the CDU not show involvement o f the PMT, which was, instead, demonstrated by intraoperative ultrason ography (false negatives). Of the 11 nonoperated patients, all showed morophological alterations at CDU, while only 7 showed hematic flow ch anges. The sensitivity of CDU was 94.2% and the specificity 100%. The positive predictive value was 100%; the negative predictive value, 75% . The results indicate that CDU may be the first imaging technique for preoperative assessment of PMT involvement in pancreatic cancer.