Titre du document / Document title

The accuracy of EUS and helical CT in the assessment of vascular invasion by peripapillary malignancy

Auteur(s) / Author(s)

TIERNEY William M. ⁽¹⁾ ; FRANCIS Isaac R. ⁽¹⁾ ; ECKHAUSER Fredrick ⁽¹⁾ ; ELTA Grace ⁽¹⁾ ; NOSTRANT Timothy T. ⁽¹⁾ ; SCHEIMAN James M. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Departments of Medicine, Radiology, and Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, ETATS-UNIS

Résumé / Abstract

Background: The relative accuracy of helical CT and EUS for defining the local resectability of peripapillary malignancies is undefined. Methods: Fifty-one patients with a peripapillary malignancy and no metastatic disease were prospectively evaluated with helical CT and EUS. Imaging results were compared with surgical staging, and a tumor was defined as resectable when there was no macroscopic or microscopic residual tumor. Results: Nine patients had surgically confirmed locally unresectable disease, which was accurately predicted by EUS in 6 patients (sensitivity 67%) and by helical CT in 3 patients (sensitivity 33%; p = 0.35). When only patients with complete EUS examinations were included, the sensitivities of EUS and helical CT for vascular invasion were 100% and 33% (p = 0.06), respectively. When all patients not undergoing surgery because of imaging evidence of locally unresectable disease were included, the sensitivities were 100% and 62.5% (p = 0.02), respectively. One of 15 patients with a tumor amenable to surgical resection was labeled as unresectable by EUS but subsequently had a local recurrence of the tumor. The specificities of EUS (93%) and helical CT (100%) were similar. Conclusion: EUS is more sensitive than helical CT for detecting vascular invasion by peripapillary malignancies and should be added to staging protocols, particularly when findings on helical CT are equivocal.

Revue / Journal Title

Gastrointestinal endoscopy   ISSN 0016-5107   CODEN GAENBQ 

Source / Source

2001, vol. 53, n^o2, pp. 182-188 (34 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1965) (Revue)

Mots-clés anglais / English Keywords

Adenocarcinoma ; Duodenal papilla ; Diagnosis ; Extension ; Blood vessel ; Endoscopy ; Echography ; Computerized axial tomography ; Spiral ; Comparative study ; Human ; Malignant tumor ; Digestive diseases ; Intestinal disease ; Sonography ; Radiodiagnosis ; Medical imagery ;

Mots-clés français / French Keywords

Adénocarcinome ; Papille duodénale ; Diagnostic ; Extension ; Vaisseau sanguin ; Endoscopie ; Echographie ; Tomodensitométrie ; Spirale ; Etude comparative ; Homme ; Tumeur maligne ; Appareil digestif pathologie ; Intestin pathologie ; Exploration ultrason ; Radiodiagnostic ; Imagerie médicale ;

Mots-clés espagnols / Spanish Keywords

Adenocarcinoma ; Papila duodenal ; Diagnóstico ; Extensión ; Vaso sanguíneo ; Endoscopía ; Ecografía ; Tomodensitometría ; Espira ; Estudio comparativo ; Hombre ; Tumor maligno ; Aparato digestivo patología ; Intestino patología ; Exploración ultrasonido ; Radiodiagnóstico ; Imageneria medical ;

Localisation / Location

INIST-CNRS, Cote INIST : 16553, 35400009793564.0080