Value of contrast- enhanced ultrasound in evaluating peripancreatic vascular invasion and resectability of pancreatic cancer

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.