Эффективность конвенциональной эхографии в сочетании с цветной ДГ в выявлении пораженных опухолевым процессом региональных лимфоузлов (ЛУ) из трансабдоминального доступа зависит от размеров ЛУ, наилучшие показатели метод демонстрирует при размерах ЛУ превышающих 2 см (чувствительность 83,3 %). Комплексное УЗИ демонстрирует достаточно высокие возможности в оценке уровня инвазии РПЖ в стенку сосудов, однако по эффективности уступает КТ (чувствительность 78,0 % против 88,0 %).
Использование современных ДГ технологий повышает эффективность УЗИ в диагностике и стадировании РПЖ, но по результативности комплексное УЗИ уступает рентгеновской КТ, что обосновывает необходимость применение последнего в алгоритме обследования больных с подозрением на РПЖ как уточняющего метода.
Ключевые слова: комплексное ультразвуковое исследование, допплерография, рентгеновская компьютерная томография, рак поджелудочной железы.
SUMMARY
Porchuk Y.D. Complex Ultrasound Examinations in Diagnostics and Determination of Pancreas Cancer Prevalence. – Manuscript.
Dissertation for a Candidate Degree in Medical Science, speciality 14.01.23.– Radiologic Diagnostics, Radiation Therapy. State Institution “National Cancer Institute” of the Ministry of Healthcare of Ukraine.− Kyiv, 2008.
The dissertation is devoted to the problem of increasing the efficiency of diagnostics and study of pancreas cancer (PC) bycombined application of conventional ultrasound examination and colour Doppler ultrasonography.
Examination results of 173 patients with pancreas cancer, 23 with chronic pancreatitis (CP), and 78 practically healthy persons of various age groups has become the basis of this thesis. Morphologic verification of the diagnosis was carried out by means of examining: operative (12) and autopsy (11) material; bioptic material obtained from laparoscopy (46); cytological material, obtained by means of interskin thin-needle aspirating puncture biopsy of pancreas (44).
The norms of basic ultrasound (US) features of pancreas structure and angioarchitecture, as well as colour Doppler ultrasonography figures of regional hemodynamics of healthy persons from various age groups were studied and specified.
Basic US and colour Doppler ultrasonography features of PC were systematized taking into account the process stage by T categories of TNM classification.
The US differential-diagnostic criteria of PC and CP, which consider the character of tumour angioarchitecture and regional hemodynamics peculiaration were established.
Studied were The possibilities,were studied and the efficiency of complex conventional ultrasound examination and CT in determination of PC local spreading over the adjacent organs was compared.
The role of US examination and colour Doppler ultrasonography in determination of pancreas tumours invasion into the great vessels considering the length of contact with tumour, as well as process localization was established.
The possibilities and limitations of complex US examination and colour Doppler ultrasonography in evaluation of regional and remote PC metastasis were determined.
The place and role of complex US in the algorithm of instrumental examination of patients with suspicion to pancreas malignant newgrowths was established.
Key words: complex ultrasound examinations, Doppler ultrasonography, X–raycomputer–aided tomography, pancreas cancer.