摘要
目的:探讨超声内镜弹性成像(endoscopic ultrasound,EUS)在胰腺占位病变良恶性鉴别中的应用价值.方法:影像学结果并经超声内镜检查确定有胰腺占位性病变的患者入选,对目标病变行超声内镜弹性成像检查,按照弹性成像5分法对组织弹性成像进行评分,将弹性成像评分为12分归为良性,3-5分归为恶性病变.结果:自2009-06/2011-06,共27例符合标准的胰腺占位病变患者入选,其中胰腺癌19例,超声内镜弹性成像评分3分(n=11)、4分(n=5)、5分(n=3),无功能性良性内分泌肿瘤(4分)及低度恶性神经内分泌肿瘤(5分)各1例,炎性病变6例,评分1分(n=1)、2分(n=3)、3分(n=2).超声内镜弹性成像对27例胰腺占位病变良恶性鉴别中24例诊断准确,诊断灵敏度100%,特异度57.14%,阳性预测值86.96%,阴性预测值100%.结论:超声内镜弹性成像对胰腺良恶性病变的鉴别具有较高的准确性,可望为疾病诊断提供新的影像学手段,但其仍为一种影像学手段,具有一定的局限性,并不替代胰腺的细胞病理学检查.
AIM： To investigate the usefulness of endoscopic ultrasound （EUS） elastography for the differential diagnosis of malignant and benign pancreatic masses. METHODS： Patients with pancreatic masses were enrolled in this study. All patients were examined by EUS and EUS elastography. Elasto- graphic pattern was scored with whole numbers from 1 to 5 based on the color of elastographic images. Scores I and 2 were classified as benign and scores 3 to 5 as malignant. RESULTS： Elastography was successfully performed in all patients and there were no proce-dure-related complications. Nineteen patients were finally diagnosed with pancreatic carci- noma, 1 with malignant pancreatic neuroen- docrine tumor, 1 with benign endocrine tumor and 6 with focal pancreatitis. According to our diagnostic criteria of elastography, the overall accuracy of EUS elastography for the differential diagnosis of focal pancreatic masses was 88.89% （24/27）, with a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 57.14%, 86.96% and 100%, respectively. CONCLUSION： EUS elastography has a rela- tively high accuracy for the differentiation of be- nign and malignant pancreatic lesions and may provide an alternative method when EUS-FNA reveals negative results or cannot be performed because of technical problems.
出处
《世界华人消化杂志》
CAS
北大核心
2012年第5期425-429,共5页
World Chinese Journal of Digestology
基金
上海市卫生局青年科研基金资助项目
No.2009Y135~~
关键词
胰腺
内窥镜超声检查
弹性成像
诊断
Pancreas
Endoscopic ultrasound
Elas-tography
Diagnosis
