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©2013 Baishideng Publishing Group Co.
World J Gastroenterol. Feb 14, 2013; 19(6): 874-881
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.874
Published online Feb 14, 2013. doi: 10.3748/wjg.v19.i6.874
Table 1 Baseline characteristics of the patient cohort
Baseline characteristics | |
Patients (n) | 397 |
Age (yr), mean ± SE | 61.43 ± 13 |
Sex (M/F) | 210/187 |
IDUS performed (n) | 397 |
Follow-up (mo), mean ± SE | 39.7 ± 23.1 |
Follow-up range (mo) | 12-100 |
Procedures (n) | |
Clinical follow-up | 95 |
Surgery | 264 |
Palliative therapy | 32 |
Calculus extraction | 6 |
Localization of stricture (CBD) | |
Proximal third | 59 |
Middle third | 46 |
Distal third | 292 |
Final diagnosis (n) | |
Normal bile duct | 25 |
Benign disease | |
Papillitis | 30 |
Ampullary adenoma | 18 |
Cholangitis | 17 |
PSC | 8 |
Mirizzi syndrome | 7 |
Choledocholithiasis | 14 |
Pancreatitis | 59 |
Pseudocyst | 4 |
Portal vein thrombosis | 1 |
Papilloma of pancreatic duct | 3 |
Choledochal cyst | 1 |
Postoperative stenosis | 1 |
Pancreatic cystadenoma | 2 |
Caroli’s syndrome | 1 |
Malignant disease | |
Cholangiocarcinoma | 85 |
Pancreatic carcinoma | 80 |
Ampullary carcinoma | 26 |
Gallbladder carcinoma | 9 |
Hepatocellular carcinoma | 6 |
Table 2 Staging results of intraductal ultrasound (n = 397)
Final diagnosis according to histopathology or long-term follow-up | |||||||
Method, classification | Benign lesion | Carcinoma | CCC | Pancreatic CA | Ampullar CA | GB CA | HCC |
IDUS, benign | 171 | 14 | 2 | 5 | 5 | 1 | 1 |
IDUS, malignant | 20 | 192 | 83 | 75 | 21 | 8 | 5 |
Table 3 Sensitivity, specificity and accuracy rates of intraductal ultrasound (n = 397)
Tumor | Sensitivity (95%CI) | Specificity (95%CI) | Accuracy (95%CI) |
All tumors | 0.93 (0.90-0.97) | 0.89 (0.85-0.94) | 0.91 (0.89-0.94) |
CCC | 0.98 (0.94-1.0) | 0.98 (0.94-1.0) | 0.92 (0.89-0.95) |
Pancreatic CA | 0.94 (0.88-0.99) | 0.90 (0.85-0.94) | 0.91 (0.87-0.94) |
Ampullary CA | 0.81 (0.66-0.96) | 0.90 (0.85-0.94) | 0.89 (0.84-0.93) |
GB CA | 0.89 (0.68-1.0) | 0.90 (0.85-0.94) | 0.90 (0.85-0.94) |
HCC | 0.83 (0.54-1.0) | 0.90 (0.85-0.94) | 0.89 (0.85-0.94) |
Table 4 Statistical analysis of intraductal ultrasound accuracy rates relating to localization of bile duct strictures (n = 397)
Localization of stenosis | N | Accuracy (95%CI) | Test for significance | P value |
Proximal third | 55/59 | 0.93 (0.87-1.0) | Proximal vs middle third | 0.958 |
Middle third | 43/46 | 0.93 (0.87-1.0) | Proximal vs distal third | 0.280 |
Distal third | 260/292 | 0.89 (0.85-0.93) | Middle vs distal third | 0.308 |
Table 5 Histopathological vs intraductal ultrasound T staging
Histopathology | ||||
IDUS | pT1 | pT2 | pT3/4 | ∑ |
uT1 | 12 | 9 | 13 | 34 |
uT2 | 1 | 26 | 24 | 51 |
uT3 | 1 | 5 | 56 | 62 |
∑ | 14 | 40 | 93 | 147 |
Sensitivity (95%CI) | 0.86 (0.67-1.0) | 0.65 (0.50-0.80) | 0.60 (0.50-0.70) | |
Specificity (95%CI) | 0.83 (0.77-0.90) | 0.77 (0.69-0.85) | 0.89 (0.81-0.97) | |
Accuracy (95%CI) | 0.84 (0.78-0.89) | 0.73 (0.66-0.81) | 0.71 (0.63-0.78) |
Table 6 N staging accuracy-histopathology vs intraductal ultrasound
Histopathology | |||
IDUS | pN0 | pN1 | ∑ |
uN0 | 44 | 23 | 67 |
uN1 | 23 | 57 | 80 |
∑ | 67 | 80 | 147 |
Sensitivity (95%CI) | 0.66 (0.61-0.81) | 0.61 (0.57-0.79) | |
Specificity (95%CI) | 0.61 (0.54-0.77) | 0.66 (0.54-0.77) | |
Accuracy (95%CI) | 0.69 (0.61-0.76) | 0.69 (0.61-0.76) |
Table 7 Meta-analysis of intraductal ultrasound accuracy in detecting bile duct malignancy
- Citation: Meister T, Heinzow HS, Woestmeyer C, Lenz P, Menzel J, Kucharzik T, Domschke W, Domagk D. Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology. World J Gastroenterol 2013; 19(6): 874-881
- URL: https://www.wjgnet.com/1007-9327/full/v19/i6/874.htm
- DOI: https://dx.doi.org/10.3748/wjg.v19.i6.874