Power Doppler Endoscopic Ultrasonography for the Differential Diagnosis Between Pancreatic Cancer and Pseudotumoral Chronic Pancreatitis
Power Doppler Endoscopic Ultrasonography for the Differential Diagnosis Between Pancreatic Cancer and Pseudotumoral Chronic Pancreatitis
复制标题
能量多普勒超声内镜鉴别诊断胰腺癌与假瘤性慢性胰腺炎
DOI：
10.7863/jum.2006.25.3.363
复制
发表时间：
2006
影响因子：
2.3
通讯作者：
F. Gorunescu
中科院分区：
文献类型：
--
作者：
A. Saftoiu;C. Popescu;S. Cazacu;D. Dumitrescu;C. Georgescu;M. Popescu;T. Ciurea;F. Gorunescu
Objective.在文献中，内镜超声检查（EUS）和EUS引导下细针穿刺活检鉴别诊断胰腺肿块的准确性各不相同，在一些研究中低至75%。本研究的目的是评估能量多普勒超声内镜在胰腺癌和假性肿瘤性慢性胰腺炎鉴别诊断中的准确性。方法.我们纳入了2002年1月至2004年8月期间连续42例胰腺肿瘤肿块患者（27例男性和15例女性）进行EUS检查。所有患者的内镜超声检查程序包括能量多普勒EUS以及EUS引导的细针抽吸。根据影像学检查、至少6个月随访和18例因诊断或姑息原因进行剖腹手术提供的信息，29例患者最终确诊为胰腺癌。结果提示胰腺肿块内无能量多普勒信号的敏感性和特异性分别为93%和77%，准确性为88%。此外，增加胰周侧支的存在所提供的信息将敏感性和特异性提高到97%和92%，准确性为95%。结论.能量多普勒超声内镜为胰腺肿块的鉴别诊断提供了有用的信息。该结果与先前的研究一致，这些研究显示胰腺癌的低血供模式，以及由于脾静脉或门静脉浸润而在晚期病例中形成侧支循环。为了更好地描述胰腺肿块的特征，有必要进一步研究动态EUS与造影剂。
Objective. The accuracy of endoscopic ultrasonography (EUS) and EUS‐guided fine‐needle aspiration for the differential diagnosis of pancreatic masses is variable in the literature, being as low as 75% in some studies. The aim of the study was to assess the accuracy of power Doppler EUS for the differential diagnosis between pancreatic cancer and pseudotumoral chronic pancreatitis. Methods. We included 42 consecutive patients with pancreatic tumor masses (27 men and 15 women) examined by EUS between January 2002 and August 2004. Endoscopic ultrasonographic procedures included power Doppler EUS as well as EUS‐guided fine‐needle aspiration in all patients. Final diagnosis of pancreatic cancer was confirmed in 29 patients on the basis of a combination of information provided by imaging tests, follow‐up of at least 6 months, and laparotomy in 18 patients for diagnostic or palliative reasons. Results. Sensitivity and specificity of the absence of power Doppler signals inside the suggestive pancreatic mass were 93% and 77%, respectively, with accuracy of 88%. Moreover, the addition of the information provided by the presence of peripancreatic collaterals improved the sensitivity and specificity to 97% and 92%, with accuracy of 95%. Conclusions. Power Doppler EUS provides useful information for the differential diagnosis of pancreatic masses. The results were in concordance with previous studies that showed a hypovascular pattern of pancreatic carcinoma, as well as the formation of collaterals in advanced cases due to the invasion of the splenic or portal veins. Further studies of dynamic EUS with contrast agents are necessary to better characterize pancreatic masses.