Literature DB >> 18026788

Improvement of intraoperative frozen section diagnosis in patients with biliary strictures by Levovist injection into the bile duct on color Doppler ultrasonography.

Takayuki Aimoto1, Eiji Uchida, Yutaka Kawahigashi, Yoshiharu Nakamura, Akira Matsushita, Akira Katsuno, Kazumitsu Chou, Masao Kawamoto, Yoichiro Yamanaka, Takashi Tajiri, Zenya Naito.   

Abstract

BACKGROUND: This study evaluates the efficiency of color Doppler ultrasonography-guided intraoperative pancreatic biopsy (CDUS-IPB) using Levovist injected into the bile duct in conjunction with stimulated acoustic emission (SAE) in patients with biliary strictures.
METHODS: The study was performed on 12 patients. After completing a conventional intraoperative pancreatic biopsy (c-IPB), each subject underwent CDUS with SAE imaging using Levovist. Upon identification of the biliary stricture, the IPB was taken from the area surrounding the stricture on the same imaging setting. Section diagnosis of the CDUS-IPB specimen was compared to that of the c-IPB specimen and resected tissue.
RESULTS: Biliary strictures were identified as enhanced areas of color Doppler signal on CDUS. CDUS-IPB provided adequate specimens from the biliary strictures in all cases and corrected false-negative diagnoses by c-IPB in three cases. Section diagnosis by CDUS-IPB corresponded to the permanent section diagnosis. There were no complications.
CONCLUSIONS: CDUS-IPB with Levovist is an accurate diagnostic tool. The method is especially useful for patients with a suspected malignant biliary stricture who show no tumor mass in preoperative images and no evidence of malignancy on cytologic examinations.

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Year:  2008        PMID: 18026788     DOI: 10.1007/s00268-007-9288-8

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


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