Endoscopic ultrasound in diagnosis of solid pancreatic lesions: Elastography or contrast-enhanced harmonic alone versus the combination.
Endoscopic ultrasound in diagnosis of solid pancreatic lesions: Elastography or contrast-enhanced harmonic alone versus the combination.
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DOI：
10.1055/s-0043-118829
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发表时间：
2017-11
影响因子：
2.6
通讯作者：
Goto H
中科院分区：
文献类型：
--
作者：
Chantarojanasiri T;Hirooka Y;Kawashima H;Ohno E;Kuwahara T;Yamamura T;Funasaka K;Nakamura M;Miyahara R;Ishigami M;Watanabe O;Hashimoto S;Hirakawa A;Ratanachu-Ek T;Goto H
超声内镜 (EUS) 弹性成像 (EUS-E) 和超声造影增强超声 (CH-EUS) 是诊断胰腺病变的有用方法。本研究旨在比较EUS-E和CH-EUS联合与单独EUS-E或CH-EUS在鉴别诊断胰腺实性病变中的准确性。 136 名患有实性胰腺病变的患者接受了 EUS，包括 EUS-E 和 CH-EUS。分别有 95 名、22 名和 19 名患者被诊断为腺癌、神经内分泌肿瘤 (NET) 和炎性假瘤。每个病例的 EUS 记录被重新排列为 3 组：EUS-E、CH-EUS 和组合。每种方式均由 3 名具有不同临床经验水平的评审员随机评审。根据每个诊断组评估每种方式的敏感性、特异性和准确性。对于联合诊断人群，通过多元逻辑回归分析比较3种方式的正确诊断比例。 对于腺癌组，EUS-E、CH-EUS及其组合的准确率分别为68.4%、65.4%和75.7%； NET 组为 83.8 %、82.4 % 和 86.8 %；炎性假瘤组为80.1%、78.7%、81.6%。 对联合诊断人群的多因素logistic回归分析表明，EUS-E和CH-EUS联合时的正确诊断比例略高于其他2种方式，但两者之间没有观察到显着差异。 与使用单独的方法相比，EUS-E 和 CH-EUS 相结合可以改善胰腺实性病变的鉴别诊断。
Endoscopic ultrasound (EUS) elastography (EUS-E) and contrast-enhanced harmonic EUS (CH-EUS) are useful methods for the diagnosis of pancreatic lesions. This study aims to compare the accuracy of combined EUS-E and CH-EUS with that of EUS-E or CH-EUS alone in the differential diagnosis of pancreatic solid lesions. One hundred thirty-six patients with solid pancreatic lesions underwent EUS with both EUS-E and CH-EUS were included. Diagnoses were classified as adenocarcinoma, neuroendocrine tumor (NET), and inflammatory pseudotumor in 95, 22, and 19 patients, respectively. EUS records in each case were rearranged into 3 groups: EUS-E, CH-EUS, and combination. Each modality was randomly reviewed by 3 reviewers with different levels of clinical experience. Sensitivity, specificity, and accuracy of each modality according to each diagnosis group were evaluated. For the combined diagnosis populations, the proportions of correct diagnoses among the 3 modalities were compared by using the multivariate logistic regression analysis. The accuracies of EUS-E, CH-EUS, and the combination of them were 68.4 %, 65.4 %, and 75.7 %, respectively, for adenocarcinoma group; 83.8 %, 82.4 %, and 86.8 % for NET group; 80.1 %, 78.7 %, and 81.6 % for inflammatory pseudotumor group. The multivariate logistic regression analysis for the combined diagnosis populations showed that the proportion of correct diagnoses when EUS-E and CH-EUS were combined was slightly higher than with the other 2 modalities, although the significant differences among them were not observed. EUS-E and CH-EUS combined may improve differential diagnosis of solid pancreatic lesions compared with use of the individual modalities.