Usefulness of Intraportal Ultrasonography in Diagnosis of Portal Vein Involvement in Pancreatobiliary Cancer

Kenichi Yanagawa, Hiroji Nishino, Kazuhiro Takeuchi, Ryugo Sawada, Yoshiaki Koh, Takaji Kaneda, Shigehiko Nishimura, Nobuya Yamada, Akira Shigesawa, Yuichi Arimoto, Toshiaki Kubo, Masaichi Ohira, Michio Sowa

The First Department of Surgery, Osaka City University of Medical School

Since June 1992, intraportal ultrasonography (IPUS) had been performed in 22 pancreatobiliary cancer patients to evaluate the degeee of portal vein involvement, which was determined by demonstrating changes in the portal vein wall directly. The degree of portal vein involvement was classified into 4 groups as V_0-3 according to the General Rules for Cancer of the Pancreas. Comparative analysis between the IPUS findings and operative or histological findings was carried out. The IPUS findings were accurate in 17 of 18 cases and of 8 cases when compared with operative and histological findings, respectively. Mass echoic lesions in the portal vein were detected in two cases, and both of them were diagnosed as tumor emboli. One actually was a tumor embolus, but the other was a portal thrombus. In conclusion, IPUS was useful in diagnosing the degree of portal vein involvement in pancreatobiliary cancer. But it is difficult to evaluate mass echoic lesions in the portal vein by IPUS, and further study will be necessary to obtained an accurate diagnosis of such lesions.

Key words
intraportal ultrasonography, portal invasion, portal thrombosis

Reprint requests
Kenichi Yanagawa The First Department of Surgery, Osaka City University of Medical School
1-5-7 Asahimachi, Abenoku, Osaka City, 545 JAPAN

Accepted
October 11, 1995

To read the PDF file you will need Abobe Reader installed on your computer.