Transhepatic intravascular ultrasound for evaluation of portal venous involvement in patients with cancer of the pancreatic head region.

P H Hannesson, C Lundstedt, Sigmund Dawiskiba, Hans Stridbeck, Ingemar Ihse

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of this study was to evaluate the ability of intravascular ultrasound to diagnose tumor involvement of the portal and the superior mesenteric veins using the preoperative percutaneous, transhepatic approach, and to compare the findings with those made at concomitant direct portography, surgery, and histopathological examination. Ten patients with a preoperative diagnosis of a resectable tumor in the pancreatic head region were examined with percutaneous transhepatic portography (PTP) and intravascular ultrasound (IVUS). The surgeon's intraoperative evaluation and the histopathological examination in combination revealed tumor involvement of the portal or superior mesenteric veins in six of the ten patients. Percutaneous transhepatic portography suggested tumor involvement of the veins in six patients but two of the examinations were false positive and another two were false negative. Intravascular ultrasound showed signs of tumor involvement in eight patients. The examination was, however, false positive in two patients, but there were no false negatives. Complications of the percutaneous transhepatic procedure occurred in six patients including severe pain, bleeding, and related death. Percutaneous transhepatic IVUS of the portal vein may be a useful tool in the preoperative selection of the subgroup of patients with tumor of the pancreatic head region that could benefit from surgery. There is a need for technical improvement as well as studies with larger patient series to definitely decide the role of the technique.
Original languageEnglish
Pages (from-to)1150-1154
JournalEuropean Radiology
Volume12
Issue number5
DOIs
Publication statusPublished - 2002

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Surgery (Lund) (013009000), Pathology, (Lund) (013030000), Diagnostic Radiology, (Lund) (013038000)

Subject classification (UKÄ)

  • Radiology, Nuclear Medicine and Medical Imaging

Free keywords

  • Pancreatic Neoplasms : surgery
  • Pancreatic Neoplasms : pathology
  • Middle Age
  • Mesenteric Veins : ultrastructure
  • Mesenteric Veins : pathology
  • Male
  • Human
  • Female
  • False Positive Reactions
  • False Negative Reactions
  • Comparative Study
  • Aged
  • Adult
  • Portography
  • Pancreatic Neoplasms : ultrasonography
  • Portal Vein : pathology
  • Portal Vein : ultrasonography

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