Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients
Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients
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DOI：
10.1055/s-2006-925158
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发表时间：
2006-04-01
期刊：
影响因子：
9.3
通讯作者：
Delpero, JR
中科院分区：
文献类型：
--
作者：
Giovannini, M;Hookey, LC;Delpero, JR
背景与研究目的：众所周知，一些疾病，如癌症，会导致组织硬度的改变。超声弹性成像是一种允许在超声检查期间评估组织弹性的技术，它为超声医师提供了可用于诊断的重要附加信息。本研究的目的是评估内镜超声弹性成像区分良性和恶性胰腺肿块和淋巴结的能力。患者和方法：在12个月的时间里，49例患者接受了由一名内镜医师进行的超声内镜（EUS）弹性成像检查。24例患者接受胰腺肿块检查（平均直径24.7±11.1 mm）， 25例患者接受31个淋巴结检查。淋巴结平均直径19.7±8.6 mm，分布于颈区（n = 3）、纵隔区（n = 17）、腹腔动脉干区（n = 5）、腹主动脉区（n = 6）。结果：胰腺肿块超声弹性图显示为良性4例，恶性20例。超声弹性图诊断恶性病变的敏感性为100%，特异性为67%。淋巴结超声弹性成像显示22例为恶性，7例为良性，2例为不确定状态。超声弹性图评价恶性淋巴结浸润的敏感性为100%，特异性为50%。结论：EUS弹性成像有可能进一步确定良性和恶性病变的组织特征，但特异性有待提高。可用于指导活检取样进行诊断。
Background and Study Aims: It is well known that some diseases, such as cancer, lead to changes in the hardness of tissue. Sonoelastography, a technique that allows the elasticity of tissue to be assessed during ultrasound examination, provides the ultrasonographer with important additional information that can be used for diagnosis. The aim of this study was to evaluate the ability of endoscopic ultrasound elastography to differentiate between benign and malignant pancreatic masses and lymph nodes.Patients and Methods: During a 12-month period, 49 patients underwent endoscopic ultrasound (EUS) examinations with elastography, conducted by a single endoscopist. Twenty-four patients underwent evaluation of a pancreatic mass (mean diameter 24.7 +/- 11.1 mm) and 25 underwent evaluation of 31 lymph nodes. The mean diameter of the lymph nodes was 19.7 +/- 8.6 mm, and they were found in the cervical area (n = 3), mediastinum (n = 17), celiac arterial trunk region (n = 5), and aortocaval region (n = 6).Results: The sonoelastography images of pancreatic masses were interpreted as benign in four cases and malignant in 20. The sensitivity and specificity of sonoelastography in the diagnosis of malignant lesions were 100% and 67%, respectively. The sonoelastography images of the lymph nodes were interpreted as showing malignancy in 22 cases, benign conditions in seven, and indeterminate status in two. The sensitivity and specificity of sonoelastography for evaluating malignant lymph-node invasion were 100% and 50%, respectively.Conclusions: EUS elastography is potentially capable of further defining the tissue characteristics of benign and malignant lesions but specifity has to be improved. It can be used to guide biopsy sampling for diagnosis.