INTRAPORTAL ENDOVASCULAR ULTRASONOGRAPHY FOR PANCREATIC-CANCER

Intraportal endovascular ultrasonography (IPEUS) is a new diagnostic p rocedure for pancreatic cancer. In portal invasion, subtle invasion an d compression are difficult to differentiate with conventional imaging techniques such as computed tomography and angiography. IPEUS is perf ormed with an 8-French, 20-MHz intravascular ultrasound catheter. IPEU S provides high-resolution, real-time images perpendicular to the port al vein axis. With IPEUS, the portal vein wall is visualized as an ech ogenic band. A subtle portal invasion can be detected by observing thi s portal vein wall. Moreover, the segment II of the extrapancreatic ne rve plexus is visualized as an echogenic area around the inferior panc reaticoduodenal artery (IPDA). The extrapancreatic nerve plexus invasi on can be diagnosed as low echoic infiltration of the area around the IPDA. In the diagnosis of portal vein and extrapancreatic nerve plexus invasion, IPEUS provides a good diagnostic value and important inform ation for the staging of local extension of the pancreatic cancer. (C) 1998 Wiley-Liss, Inc.