Comparison of angiography and ultrasound in the evaluation of the portal venous system in pancreatic carcinoma

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Abstract
Detailed images of upper abdominal vascular anatomy can now be obtained by experienced operators using modern real‐time ultrasound scanners. To help determine the role of real‐time ultrasound in preoperative evaluation of pancreatic carcinoma, ultrasound and angiographic results were compared in a series of 45 patients admitted with documented carcinoma of the pancreas. When surgical results were available, these were compared with the ultrasound and angiographic findings. The main tributaries of the portal system were evaluated with ultrasound and angiography for evidence of compression, displacement, or occlusion. A sensitivity of 90%and specificity of 95% were achieved for splenic vein abnormalities by ultrasound compared to angiography. For portal vein evaluation, sensitivity was 75%, and specificity was 100%, whereas for the superior mesenteric vein a sensitivity of 100% and a specificity of 94% were attained. Ultrasound can make angiography prior to laparotomy unnecessary in many cases if thorough evaluation of the portal venous system is emphasized during the initial ultrasound study.