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>Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis
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Diagnosis of Cancer Spread Using Percutaneous Transhepatic Biliary Cholangioscopy-guided Ultrasonography for Malignant Bile Duct Stenosis
The characteristics of sites of intramural cancer spread were examined by comparing theintraductal ultrasonography (IDUS) and wall thickening findings at sites of intramural cancerspread and non-spread, in patients with malignant bile duct stenosis who had undergonepercutaneous transhepatic biliary drainage (PTBD).The subjects were ten patients with extrahepatic bile duct cancer, two with pancreaticcancer, one with cancer of the gallbladder, and one with cancer of the papilla of Vater whounderwent preoperative IDUS. From these patients, 50 IDUS slices were examined with acongruent relationship with the histologic section of resected tissue. The maximumthickening, minimum thickening, maximum/minimum thickening ratio, and form factor of themedial and lateral margins of the medial hypoechoic layer were determined using diagnosticimaging, and the results were compared at sites of cancer spread and non-spread.Twelve slices were obtained from the site of stenosis, 14 from sites of cancer spread, and 24from non-spread sites. The maximum thickening, minimum thickening, and maximum/minimumthickening ratio differed significantly between the sites of spread and the non-spread.The absolute values for wall thickening are useful for diagnosing the presence of intramuralspread in patients with malignant biliary duct stenosis.
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