Clinical Gastroenterology Vol.18 No.8(4)

Theme Diagnosis of Biliary Tract Cancer -- Present Status and Perspective
Title Ultrasonographic Diagnosis of Biliary Tract Cancer -- Detection and Characterization
Publish Date 2003/07
Author Yuji Horiguchi Department of Gastroenterology, Fujita Health University School of Medicine
Author Hideo Imai Department of Gastroenterology, Fujita Health University School of Medicine
Author Tomohiro Suzuki Department of Gastroenterology, Fujita Health University School of Medicine
Author Keisuke Osakabe Department of Gastroenterology, Fujita Health University School of Medicine
Author Tohru Nishikawa Laboratory Medicine, Fujita Health University School of Medicine
[ Summary ] We reviewed the diagnostic utility of extracorporeal ultrasonography for biliary tract cancer. Tissue harmonic imaging (THI) has enable us to make some reductions in artifacts in addition to improvements in the spatial resolution of B-mode images. Therefore, polypoid and/or elevated lesions of the gallbladder may be clearly delineated. Additionally the wall-thickness of the gallbladder can be analyzed more precisely with THI combined with power Doppler imaging (PDI). PDI allowed us to archieve quantitative evaluation of blood flow in the cystic vessels; maximal velocity (Vmax), pulsatile index (PI), and resistance index (RI). From our results, these parameters seem to be available for differentiation of small polypoid lesions and wall-thickening changes.
Contrast-enhanced US (CEUS), using Levovist, is a new modality for evaluating hemodynamics. The main advantages of this imaging are thought to be acquisition of semi-real-time imaging of vasculatures and perfusion imaging of the tissue. CEUS is also efficient for the estimation of tumor extension in the gallbladder and bile duct cancer into adjacent organs: liver, pancreas, etc.
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