胰腺癌血管受侵程度的彩超评估

 目的　评价彩色多普勒成像诊断胰腺癌周围血管受侵情况的准确性。方法　应用彩超对47例胰腺癌病人胰周血管受侵情况进行预测评估，并与外科结果进行了比较。结果　通过手术的47例病人受侵血管的诊断，彩超的敏感性、特异性和准确性分别是80%、91%和85%。阳性和阴性预测值分别是91%和80%。结论　彩超在评价胰腺癌血管受侵时有一定敏感性和高度特异性。当彩超检测到有血管包裹时，可以做出不可切除的肯定诊断，可以避免进一步的诊断过程。

Color Doppler Imaging in the Assessment of Vascular Involvement by Pancreatic Carcinoma

Objective To assess the accuracy of color Doppler imaging in diagnosing the involvement of peripancreatic vessels by pancreatic carcinoma.Methods We prospectively evaluated the color Doppler images of 47 pancreatic carcinomas.Our evaluation focused on vascular involvement.Absence of contact or a short contiguity(≤2cm) between tumors and peripancreatic vessels was considered to be a sign of resectability on color Doppler imaging;a long contiguity(＞2cm),compression,encasement,or thrombosis was considered to be a sign of unresectability.In all patients,the sonographic diagnosis was compared with the surgical results.Results With color imaging,we detected signs of vascular involvement in 20 of 22 patients in whom vascular involvement was found at surgery,we detected no vascular in 20 of 25 patients in whom no vascular involvement was found at surgery.No false-positive diagnosis occurred when vascular encasement was revealed by color Doppler imaging.For diagnosis of vascular involvement,the sensitivity,specifity and overall accuracy of color Doppler imaging were 80%,91%and 85%,respectively;Positive and negative predictive values were 91%and 80%,respectively.Conclusion Color Doppler imaging is a sensitive and highly specific technique in assessing vascular involverment by pancreatic cancer when absence of contact or vascular encasement is seen.When vascular encasement is detected by color Doppler imaging,a definitive diagnosis of unresectability can be made,and further diagnostic procedures can be avoided.