Utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas
Utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas
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DOI：
10.1016/j.ultrasmedbio.2007.09.018
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发表时间：
2008-04-01
影响因子：
2.9
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Sakamoto, Hiroki;Kitano, Masayuki;Kudo, Masatoshi
我们研究的目的是评估内镜超声（EUS）和超声内镜造影（CE - EUS）在胰腺肿瘤（特别是2厘米及以下的肿瘤）的显示及鉴别诊断中的应用价值。我们比较了不同的诊断方法，即对比增强多排螺旋计算机断层扫描（CE - CT）、采用能量多普勒的内镜超声（PD - EUS）以及超声内镜造影（CE - EUS）在胰腺肿瘤检测和鉴别诊断中的作用。该研究纳入了156例连续的疑似胰腺肿瘤患者，这些患者均接受了CE - CT、内镜超声检查，随后又进行了PD - EUS和CE - EUS检查。超声内镜造影是采用能量多普勒模式，使用超声造影剂利声显（Levovist®）进行的。在接受检查的156例患者中，有36例患者的肿瘤≤2厘米。对于检测2厘米及以下的胰腺癌，内镜超声的敏感度（94.4%）显著高于对比增强多排螺旋计算机断层扫描（50%）。对于2厘米及以下的小胰腺肿瘤，在鉴别导管癌与其他肿瘤方面，对比增强多排螺旋计算机断层扫描、采用能量多普勒的内镜超声以及超声内镜造影的敏感度分别为50.0%、11.0%和83.3%。超声内镜造影的敏感度显著高于采用能量多普勒的内镜超声和对比增强多排螺旋计算机断层扫描。内镜超声及随后进行的超声内镜造影在检测和鉴别小胰腺肿瘤方面比对比增强多排螺旋计算机断层扫描更为敏感。
The aim of our study was to assess the utility of endoscopic ultrasonography (EUS) and contrast-enhanced EUS (CE-EUS) for the depiction and differential diagnosis of pancreatic tumors focusing in particularly those 2 cm or smaller. We compared different diagnostic procedures, contrast-enhanced multidetector computed tomography (CE-CT) and EUS with the use of power Doppler (PD-EUS) and CE-EUS for detection and differential diagnosis of pancreatic tumors. The study included 156 consecutive patients with suspected pancreatic tumors, who underwent CE-CT, and EUS followed by PD-EUS and CE-EUS. CE-EUS was performed by power Doppler mode using sonographic contrast agent Levovist (R). Thirty-six of 156 patients examined had tumors of :52 cm. EUS had significantly higher sensitivity (94.4%) for detection of pancreatic carcinomas of 2 cm or less in comparison to CE-CT (50%). For small pancreatic tumor of 2 cm or less, sensitivities for differentiating ductal carcinomas from other tumors were 50.0%, 11.0% and 83.3% for CE-CT, PD-EUS and CE-EUS. CE-EUS was significantly more sensitive than PD-EUS and CE-CT. EUS and subsequent CE-EUS are more sensitive than CE-CT in the detection and the differentiation of small pancreatic tumors.