Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer
Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer
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DOI：
10.3748/wjg.v12.i2.246
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发表时间：
2006-01-14
影响因子：
4.3
通讯作者：
Dietrich, Christoph F.
中科院分区：
文献类型：
--
作者：
Hocke, Michael;Schulze, Ewald;Dietrich, Christoph F.
目的：评价超声造影在胰腺癌与炎症鉴别诊断中的价值。方法：对86例可疑慢性胰腺炎患者(年龄：62±12岁；对胰腺病变进行常规内窥镜B超、能量多普勒超声和对比增强能量模式(Hitachi EUB 525，SonoVue(R)，2.4mL，BRACO)检查，采用以下恶性病变标准：常规功率多普勒扫描无法检测到血管形成，使用SonoVue(R)对比增强技术短距离出现不规则的动脉血管，病变内没有可检测到的静脉血管。如果一个标准可检测到[金标准内窥镜超声(EUS)引导下的细针吸取细胞学，手术]，则认为是恶性病变。以注射SonoVue(R)前未发现血管形成、注射SonoVue(R)后至少20 mm内有规律性血管出现及动脉、静脉血管显影为诊断标准。结果：常规超声诊断胰腺癌的敏感性为73.2%，特异性为83.3%。56例胰腺恶性病变中51例EUS造影敏感性提高到91.1%，30例慢性炎症性胰腺疾病中28例特异性93.3%。结论：超声造影提高了慢性胰腺炎与胰腺癌的鉴别诊断水平。(C)2006年WJG出版社。版权所有。
Aim: To evaluate the contrast-enhanced endosonography as a method of differentiating inflammation from pancreatic carcinoma based on perfusion characteristics of microvessels.METHODS: In 86 patients with suspected chronic pancreatitis (age: 62 +/- 12 years; sex: f/m 38/48), pancreatic lesions were examined by conventional endoscopic B-mode, power Doppler ultrasound and contrast-enhanced power mode (Hitachi EUB 525, SonoVue((R)), 2.4 mL, Bracco) using the following criteria for malignant lesions: no detectable vascularisation using conventional power Doppler scanning, irregular appearance of arterial vessels over a short distance using SonoVue((R)) contrast-enhanced technique and no detectable venous vessels inside the lesion. A malignant lesion was assumed if a criteria were detectable [gold standard endoscopic ultrasound (EUS)-guided fine needle aspiration cytology, operation],. The criteria of chronic pancreatitis without neoplasia were defined as no detectable vascularisation before injection of SonoVue((R)), regular appearance of vessels over a distance of at least 20 mm after injection of SonoVue((R)) and detection of arterial and venous vessels.RESULTS: The sensitivity and specificity of conventional US were 73.2% and 83.3% respectively for pancreatic cancer. The sensitivity of contrast-enhanced EUS increased to 91.1% in 51 of 56 patients with malignant pancreatic lesion and the specificity increased to 93.3% in 28 of 30 patients with chronic inflammatory pancreatic disease.CONCLUSION: Contrast-enhanced endoscopic ultrasound improves the differentiation between chronic pancreatitis and pancreatic carcinoma. (c) 2006 The WJG Press. All rights reserved.