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Value of contrast- enhanced ultrasound in evaluating peripancreatic vascular invasion and resectability of pancreatic cancer
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摘要:
目的应用超声造影（CEUS）观察胰腺癌侵犯周围血管情况,探讨术前CEUS评估胰腺癌可切除性的价值。方法回顾性分析2012年12月-2014年10月在中国医科大学附属盛京医院就诊的经手术探查或术后病理证实为胰腺癌的患者25例,术前均行CEUS检查。观察病灶与胰周大血管的关系,评估受侵犯程度,同时进行评分,与术中探查及术后病理结果进行对比,分别计算胰周大血管受侵率、术前CEUS评估胰周血管受侵程度的敏感性、特异性,CEUS评估胰腺癌可切除性的敏感性、特异性、阳性预测值、阴性预测值、总符合率及约登指数。结果术前CEUS诊断血管受侵42条,术中所见血管受侵41条;术前CEUS评估可切除者17例,术中探查判定可切除15例,CEUS评估胰腺癌可切除的敏感性为93.3%,特异性为70.0%,总符合率为84.0%,假阳性率为30.0%,假阴性率为6.7%,阳性预测值为82.4%,阴性预测值为87.5%,约登指数为0.633。结论 CEUS评估胰腺癌周围大血管受侵程度与术中判断相比具有较高的敏感性和特异性,CEUS评估胰腺癌可切除性与术中判断对比,具有较高的敏感性、特异性及符合率,能较为准确的评估胰腺癌...
Abstract:Objective To investigate the value of preoperative contrast- enhanced ultrasound( CEUS) in evaluating peripancreatic vascular invasion and resectability of pancreatic cancer. Methods A retrospective analysis was performed for the clinical data of 25 patients with pancreatic cancer confirmed by surgical exploration or postoperative pathological examination,who visited Shengjing Hospital of China Medical University from December 2012 to October 2014,and all the patients underwent CEUS before surgery. The relationship between the lesion and the peripancreatic vessels was observed,the degree of invasion was evaluated,and related scores were measured. These results were compared with the results of intraoperative exploration and postoperative pathological results. The rate of peripancreatic vascular invasion,sensitivity and specificity of preoperative CEUS in evaluating the degree of peripancreatic vascular invasion,and sensitivity,specificity,positive predictive value,negative predictive value,overall coincidence rate,and Youden index of CEUS in evaluating the resectability of pancreatic cancer were calculated. Results Preoperative CEUS showed that 42 vessels were invaded,while intraoperative exploration showed41 vessels were invaded. A total of 17 patients were considered resectable by CEUS,while 15 patients were considered resectable by intraoperative exploration. In evaluating the resectability of pancreatic cancer,CEUS had a sensitivity of 93. 3%,a specificity of 70. 0%,an overall coincidence rate of 84. 0%,a false positive rate of 30. 0%,a false negative rate of 6. 7%,a positive predictive value of 82. 4%,a negative predictive value of 87. 5%,and a Youden index of 0. 633. Conclusion Compared with intraoperative exploration,CEUS has higher sensitivity and specificity in evaluating the degree of peripancreatic vascular invasion and higher sensitivity,specificity,and coincidence rate in evaluating the resectability of pancreatic cancer. CEUS can accurately evaluate the degree of peripancreatic vascular invasion and provides a new method for preoperative evaluation of the resectability of pancreatic cancer.
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Key words:
- pancreatic neoplasms /
- pancreatectomy /
- contrast-enhanced ultrasound
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