超声双重造影评价胰腺癌侵犯胰周血管的初步应用

Preliminary application of double contrast-enhanced ultrasonography to assess the peripancreatic vascular invasion of pancreatic carcinoma

目的探讨超声双重造影（DcEus）在评价胰腺癌侵犯胰周血管中的应用价值。方法经手术病理证实的胰腺癌患者28例，术前行DCEUS检查，观察病灶与周围血管的关系，判断血管受侵犯的程度，并与手术结果进行对比。采用Kappa法对该方法的重复性进行检验。结果28例患者中，术中诊断血管侵犯者21例，无血管侵犯者7例。DCEUS判断胰周血管受侵犯者18例，无血管侵犯者10例，其诊断灵敏度为85．71％，特异度为100％，阳性预测值为100％，阴性预测值为70．00％，准确率为89．29％，且具有较高的重复性（Kappa观察者间=0．75，Kappa观察者内=0．80）。结论DCEUS可以准确、可靠地评价胰腺癌对胰周血管的侵犯情况。

Objective To investigate the clinical value of double contrast-enhanced ultrasonography （DCEUS） in assessing the peripancreatic vascular invasion of pancreatic carcinoma. Methods Twenty-eight patients with pancreatic cancer confirmed by postoperative pathology were examined by DCEUS preoperatively. The relationship between neoplasms and peripancreatic vessels was analyzed for assessing whether vascular invasion of pancreatic cancer had occurred. The sensitivity, specificity, positive predictive value,negative predictive value and accuracy of DCEUS in evaluating vascular involvement were calculated by using the surgical results as a gold standard. Kappa test was used for assessing the intra- and interobserver reliability of DCEUS. Results In total 28 patients,21 cases were diagnosed as vascular invasion, whereas,7 cases were noninvasive by surgical results. By DCEUS, 18 cases were assessed as positive involvement of vessels, whereas, 10 cases were negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of DCEUS in evaluating vascular involvement were 85.71 %, 100%, 100 0/00,70.00 % and 89.29 % respectively, and with higher reliability （Kappa inter = 0.75, Kappa intra = 0.80）. Conclusions DCEUS could be considered as a novel method to assess vascular invasion of pancreatic carcinoma accurately and reliably.