Value of contrast‐enhanced harmonic endoscopic ultrasound for diagnosing hepatic metastases of pancreatic cancer: A prospective study
Value of contrast‐enhanced harmonic endoscopic ultrasound for diagnosing hepatic metastases of pancreatic cancer: A prospective study
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对比增强谐波内镜超声诊断胰腺癌肝转移的价值：一项前瞻性研究
DOI：
10.1111/jgh.15661
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发表时间：
2021
影响因子：
4.1
通讯作者：
Kitano Masayuki
中科院分区：
文献类型：
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作者：
Emori Tomoya;Nuta Junya;Kawaji Yuki;Tamura Takashi;Hatamaru Keiichi;Itonaga Masahiro;Yamashita Yasunobu;Ashida Reiko;Shimokawa Toshio;Koike Masataka;Ikoma Akira;Sonomura Tetsuo;Kawai Manabu;Kitano Masayuki
背景和目的本研究旨在比较对比增强谐波内镜超声（CH‐EUS）与基础B模式内镜超声（EUS）和对比增强计算机断层扫描（CE‐CT）诊断胰腺癌左肝叶转移的价值。比较EUS + CH-EUS与其他两种检查方法的检出率。在仅转移灶<10 mm的患者中进行了模态间检出率的亚组比较。由于EUS加CH-EUS结果而改变临床分期和治疗策略的胰腺癌患者的数量也进行了评估。对于左肝叶转移瘤的总体检测，EUS联合CH-EUS的准确性（94.3%）显著高于CE-CT（86.7%）和单独EUS（87.6%）（分别为P= 0.021和P = 0.020）。对于< 10 mm的左肝叶转移瘤，EUS联合CH-EUS（93.3%）显著上级CE-CT（84.4%）和单独EUS（85.6%）（分别为P= 0.021和P = 0.020）。在11例仅CH-EUS允许检测肝转移的患者中，有5例在CH-EUS.ConclusionThis研究表明，EUS + CH-EUS在检测肝左叶转移的准确性方面优于CE-CT和EUS单独检测，特别是小肝转移和准确分期。
Background and AimsThis study aimed to compare contrast‐enhanced harmonic endoscopic ultrasound (CH‐EUS) with fundamental B‐mode endoscopic ultrasonography (EUS) and contrast‐enhanced computed tomography (CE‐CT) for the diagnosis of left hepatic lobe metastases of pancreatic adenocarcinoma.MethodsIn this single‐center prospective study, CE‐CT, EUS, and CH‐EUS were performed to detect left hepatic lobe metastases in patients with pancreatic adenocarcinoma, and the detection rates were compared between EUS plus CH‐EUS and the other two modalities. Subgroup comparisons of between‐modality detection rate were performed in patients with only metastases of <10 mm. The number of pancreatic adenocarcinoma patients whose clinical stage and treatment strategy were changed because of EUS plus CH‐EUS findings was also assessed.ResultsThirty‐one patients were diagnosed with left hepatic lobe metastases. For overall detection of left hepatic lobe metastases, EUS plus CH‐EUS had significantly higher accuracy (94.3%) than CE‐CT (86.7%) and EUS alone (87.6%) (P= 0.021 andP= 0.020, respectively). For detection of left hepatic lobe metastases < 10 mm, EUS plus CH‐EUS (93.3%) was significantly superior to CE‐CT (84.4%) and EUS alone (85.6%) (P= 0.021 andP= 0.020, respectively). In five of the 11 patients in whom only CH‐EUS allowed detection of hepatic metastases, the stage and/or treatment strategy of the pancreatic adenocarcinoma was changed after CH‐EUS.ConclusionThis study demonstrated that EUS plus CH‐EUS has advantages over CE‐CT and EUS alone with regard to the accuracy of detecting left hepatic lobe metastases, particularly small hepatic metastases and accurate staging.