超声内镜与常规影像学检查在胰腺占位性病变中的诊断价值比较  

The diagnostic value of endoscopic ultrasonography and conventional imaging in pancreatic occupying lesions

作　　者：罗培培 王文瑾 王思瑶 崔一晗 张娟[1] 李红霞[1] 和水祥[1] 贾皑[1] LUO Peipei;WANG Wenjin;WANG Siyao;CUI Yihan;ZHANG Juan;LI Hongxia;HE Shuixiang;JIA Ai(Department of Gastroenterology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院消化内科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2022年第6期856-860,共5页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：陕西省重点研发项目(No.2018SF-009)。

摘　　要：目的比较超声内镜(endoscopic ultrasonography,EUS)与常规影像学在胰腺占位性病变中的诊断价值,为胰腺占位性病变的诊断提供指导。方法选取2012年9月至2019年12月在西安交通大学第一附属医院消化内窥镜室行EUS检查,经EUS医师严格筛选并诊断为胰腺原发占位性病变的病例作为研究对象,并同期收集常规影像学检查结果及患者的年龄、性别、肿瘤标志物及血、尿淀粉酶和血清脂肪酶相关资料及数据。比较EUS与常规影像学检查方法对胰腺占位性病变的诊断灵敏度、特异度、准确度等,评价EUS在胰腺占位性病变中的诊断价值。结果共纳入病例188例,男性病例多于女性病例;肿瘤组患者的年龄高于非肿瘤组患者,肿瘤标志物血清CA-199和癌胚抗原(CEA)水平明显高于非肿瘤组。EUS对胰腺占位性病变诊断的灵敏度(95.5%)显著优于经腹超声(54.4%)、平扫CT(57.1%)、增强CT(75%)、MRI(66.7%)和PET-CT(72.7%)等常规影像学检查方法。EUS对胰腺占位性病变的诊断准确度(91.5%)显著优于经腹超声(58.3%)、平扫CT(57.1%)、增强CT(74.6%)、MRI(62.5%)、PET-CT(66.7%)。EUS对胰腺占位性病变的诊断阴性预测值(76.7%)显著优于经腹超声(27.9%)、平扫CT(22.9%)、增强CT(38.1%)。EUS对胰腺占位性病变的诊断阳性预测值(94.3%)略优于经腹超声(90.2%)、平扫CT(85.7%)、增强CT(92.9%)。结论EUS在胰腺占位性病变中的诊断灵敏度、准确度显著优于经腹超声、平扫CT、增强CT、MRI及PET-CT等常规影像学检查方法;诊断阴性预测值显著优于经腹超声、平扫CT及增强CT。Objective To compare the diagnostic value of endoscopic ultrasonography(EUS)with conventional imaging in pancreatic occupying lesions so as to provide guidance for the diagnosis of pancreatic occupying lesions.Methods We selected patients who underwent EUS in the Digestive Endoscopy Room of The First Affiliated Hospital of Xi’an Jiaotong University from September 2012 to December 2019 and were strictly screened by ultrasound endoscopists and diagnosed as pancreatic space-occupying lesions as the study subjects,and collected routine imaging examination results and related information and data of the patients(age,gender,tumor markers,blood amylase,urine amylase,and serum lipase)at the same time.We compared the sensitivity,specificity and accuracy of EUS and conventional imaging methods in the diagnosis of pancreatic space-occupying lesions,and evaluated their diagnostic value.Results A total of 188 cases were included,with more male ones than female ones.The age of patients in the tumor group was higher than that in the non-tumor group,and the levels of tumor markers serum CA-199 and CEA were significantly higher than those in the non-tumor group.The diagnostic sensitivity of pancreatic space-occupying lesions supported EUS(95.5%),which was significantly better than that of transabdominal ultrasound(54.4%),plain CT(57.1%),enhanced CT(75%),MRI(66.7%),PETCT(72.7%)and other conventional imaging examination methods.The diagnostic accuracy of pancreatic spaceoccupying lesions supported EUS(91.5%),better than transabdominal ultrasound(58.3%),plain CT(57.1%),enhanced CT(74.6%),MRI(62.5%),and PET-CT(66.7%).The negative predictive value of the diagnosis of pancreatic space-occupying lesions supported EUS(76.7%),better than transabdominal ultrasound(27.9%),plain CT(22.9%),and enhanced CT(38.1%).Conclusion In the diagnosis of pancreatic space-occupying lesions,EUS is significantly better than conventional imaging methods such as transabdominal ultrasound,plain CT,enhanced CT,MRI,and PET-CT,and the negative predictive value

关 键 词：超声内镜 超声内镜引导下细针穿刺活检 胰腺占位性病变 诊断 并发症 

分 类 号：R576[医药卫生—消化系统]