内镜超声检查术对胰腺肿瘤早期诊断的价值  

The clinical value of endoscopic ultrasonography in early diagnosis of pancreatic tumor

作　　者：金震东[1] 蔡振寨[1] 李兆申[1] 邹多武[1] 湛先保[1] 陈洁[1] 许国铭[1] 

机构地区：[1]第二军医大学附属长海医院消化内科,上海200433

出　　处：《中华内科杂志》2007年第12期984-987,共4页Chinese Journal of Internal Medicine

基　　金：上海市自然科学基金(062R14113)

摘　　要：目的探讨内镜超声检查术(EUS)、管内超声检查术(IDUS)及超声内镜引导下细针穿刺术(EUS-FNA)对胰腺肿瘤早期诊断的价值。方法回顾性分析和比较188例胰腺小占位病灶的EUS、IDUS、EUS-FNA 及其他影像学检查结果。结果 (1)EUS 诊断小胰腺癌的准确率是95.6%(44/46),优于 B 超58.6%(27/46)、CT 77.4%(24/31)、MRI 76.2%(16/21)及内镜逆行胰胆管造影术(ERCP)85.3%(29/34)。小胰腺癌 EUS 声像图主要表现为类圆形、边界清楚、边缘不规则的低回声肿块,内部回声多均匀。(2)25例胰腺小占位病灶行 IDUS 检查,其准确率是100.0%(25/25),明显优于 B 超32.0%(8/25)、CT 52.9%(9/17)及 MRI 57.9%(11/19)等检查。(3)18例胰腺小占位病灶行 EUS-FNA,其准确率是66.7%(12/18)。(4)EUS 诊断胰腺假性囊肿的准确率是100.0%(27/27),明显优于 B 超52.0%(13/25)、CT 66.7%(12/18)、MRI 82.4%(14/17)及 ERCP 78.9%(15/19);对胰腺囊性肿瘤分类鉴别诊断总的准确率是57.7%(15/26),优于 B 超19.2%(5/26)、CT36.4%(8/22)、MRI 37.5%(6/16)及 ERCP 50.0%(7/14)等检查。结论 EUS、IDUS 及 EUS-FNA 对胰腺肿瘤的早期诊断具有重要价值。Objective To investigate the clinical value of endoscopic uhrasonography （EUS） and intraductal ultrasonography （IDUS） compared with the other imaging examination in the early diagnosis of pancreatic tumor. Methods Retrospect studied of 188 cases of small pancreatic lesions （ less than 3 cm in diameter） detected by EUS,IDUS and the other imaging examination at Changhai hospital from October 1992 to September 2006. Results （ 1 ） The accurate rate of small pancreatic cancer diagnosed by EUS was 95.6%, and it is better compared with US （ 58. 6% ）, CT （77.4%）, MRI （76. 2% ） and ERCP （ 85.3 % ）. The most common endosonographic features of small pancreatic cancer were alike round, irregular edge, hypoechoic mass with uniformity internal echo. （2） IDUS was performed ＂in 25 cases of small pancreatic lesions, the accurate rate of diagnosis was 100% （25/25）, and it is better compared with US 32. 0% （8/25） ,CT 52. 9% （9/17） and MRI 57.9% （11/19）. （3） EUS guided FNA（EUS-FNA） was performed in 18 cases of small pancreatic lesions, the accurate rate of diagnosis was 66.7% （12/18）. （4） The accurate rate of pseudocyst diagnosis by EUS was 100. 0% （27/27）, it is better compared with US 52. 0% （ 13/25 ）, CT 66. 7% （ 12/18 ）, MRI 82.4% （ 14/17 ） and ERCP 78. 9% （ 15/19 ） ; and the overall accurate rate of diagnosis of cystic pancreatic tumors by EUS was 57.7% （15/26）,it is better compared with US 19. 2% （5/26） , CT36.4% （8/22）, MRI 37.5% （6/16）and ERCP 50.0% （7/14）. Conclusions EUS and IDUS were better than the other imaging examinations in the detection of small pancreatic tumors.

关 键 词：胰腺肿瘤 内镜超声检查术 早期诊断 

分 类 号：R735.9[医药卫生—肿瘤]