Diagnostic value of endoscopic ultrasoundguided d

Authors: Kunal Das Masatoshi Kudo Masayuki Kitano Hiroki Sakamoto Takamitsu Komaki Tadayuki Takagi Kenji Yamao

Publish Date: 2013/01/23

Volume: 40, Issue: 3, Pages: 211-218

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Abstract

Ultrasound using microbubblebased contrast agents is useful for vascular imaging Directional eFLOW DeFLOW is a novel technology for vascular assessment that provides high spatial and temporal resolution The purpose of this study was to investigate the utility of endoscopic ultrasound EUSguided DeFlow before and after administration of an ultrasound contrast agent USCA for assessing the vascularity of solid pancreatic lesionsDeFlow was compared to power Doppler EUS PDEUS or color Doppler EUS CDEUS before and after USCA injection We also evaluated the Visual Vascular Assessment ViVA scale for the estimation of vascularity and investigated its reliability using the interclass correlation coefficient ICC From January 2007 to March 2007 35 patients mean age 645 years old age range 28–81 years underwent EUS followed by DeFLOW EUS PDEUS and CDEUS before and after administration of USCA The pancreatic parenchymal ViVA score pancreatic vascular pattern and ICC were evaluated for all lesionsConcerning the sensitivity for detection of the hypovascular pattern in pancreatic adenocarcinoma DeFLOW before and after USCA had similar sensitivity to PDEUS before and after USCA and CDEUS before and after USCA DeFLOW after contrast showed the highest accuracy 823  and negative predictive value 538  among all the modalities investigated There was a good correlation among the ViVA scores for DeFLOW before contrast those for DeFLOW EUS and those for PDEUS and CDEUS The reliability of the ViVA scale was excellent with an ICC of 081 In conclusion DeFLOW EUS is a sensitive reliable and highly accurate method of assessment of pancreatic vascularity DeFLOW EUS with contrast was more sensitive than PDEUS and CDEUS for assessment of pancreatic vascularity

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