Evaluation of pancreatic microvasculature by contrast-enhanced endosonography with high resolution -application to diagnosis and treatment-

点击翻译按钮获取中文摘要

The purposes of the present study were developing an echoendoscope equipped with contrast-harmonic mode for 2^<nd> generation of contrast agents and establishing the method to observe microcirculation of digestive organs by means of it. During the period from 2003 to 2004, we succeeded to invent contrast-harmonic mode that is suite for 2^<nd> generation of contrast agents and to develop a microconvex probe available for the mode. Furthermore, we observed microcirculation of digestive organs in dogs with the probe. In 2005, we made an animal model of pancreatic carcinomas by ablating a part of the pancreas, which resulted in a hypovascular lesion, and observed the vascularity of the lesion. Those results suggested the possibility to observe microcirculation of pancreatic carcinomas. We also evaluated the clinical significance of the contrast-enhanced harmonic ultrasonography. Through our studies, it was suggested that the contrast-enhanced ultrasonography is useful for depicting pancreatic carcinomas (Gut 2004, 53, 854-859), evaluating the response of pancreatic carcinomas to chemotherapy (J Gastroenterol 2006 in press) and estimating the malignant potential of gastrointestinal stromal tumors (J Gastroenterol 2005, 40, 247-255). We reported that endosonography guided celiac plexus neurolysis required computed tomography when B mode was employed (Digestive Endoscopy 2006, in press). Because the 2^<nd> generation of contrast agents have not been permitted to use in Japan, we performed the clinical trial of contrast-enhanced harmonic endosonography at Bethesda general hospital in Germany where one of 2^<nd> generation of contrast agents, SonoVue, were permitted for clinical use. The contrast-enhanced endosonography was performed in 17 cases. It visualized the parenchymal images of pancreatic and gastrointestinal stromal tumors that previous endosonography failed to depict. This result demonstrated that contrast-enhanced endosonography was available for clinical purpose.