造影增強(qiáng)EUS與胰腺疾病診治4課件

1、ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u 胰腺囊性病變診斷及良惡性鑒別胰腺囊性病變診斷及良惡性鑒別ohno,et al. ann surg,2009ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u 胰腺囊性病變診斷及良惡性鑒別胰腺囊性病變診斷及良惡性鑒別ohno,et al. ann surg,2009ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u 胰腺囊性病變診斷及良惡性鑒別胰腺囊性病變診斷及良惡性鑒別l results: 42, 26, 16, and 3 were pathologically diagnosed as adenoma, nonin

2、vasive carcinoma, invasive ipmns, and coexistent invasive ductal cancer, respectively. l multivariable logistic regression analysis showed that types iii/iv mural nodule (odds ratio=10.8; 95% confidential intervals=2.75-56.1) and symptomatic ipmns (odds ratio=4.31; 95% confidential intervals =1.37-1

3、4.7) were significant for malignancy. types iii （88.9%） and iv （91.7%）mural nodules were more frequently associated with malignancy, particularly invasive cancer. l the diagnosis of ipmns with types iii or iv mural nodule as malignant resulted in a sensitivity of 60%, specificity of 92.9%, and accur

4、acy of 75.9%.ohno,et al. ann surg,2009ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u ce-eus vs ce-ct/mrilsakamoto h, et al. utility of contrast-enhanced endoscopic ultrasonography for diagnosis of small pancreatic carcinomas. ultrasound med biol. 2008;34(4):525-532.l在納入研究的156例患者中有36例最終證實為2cm的胰腺癌，作者比較了ce-eus與ce-ct發(fā)現(xiàn)和

5、鑒別胰腺癌的能力，結(jié)果表明前者敏感性更高（94.4% vs 50%）ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u ce-eus vs eusl由于病變與周圍胰腺實質(zhì)的血供存在差異，ce-eus使胰腺癌、腫塊型胰腺炎、胰腺神經(jīng)內(nèi)分泌腫瘤等顯示更清晰，對此類病變的診斷和鑒別診斷更加準(zhǔn)確；定量諧波ce-eus進(jìn)一步提高其準(zhǔn)確率和客觀性。l kitano m, kudo m, yamao k.et al. characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmo

6、nic endoscopic ultrasonography. am j gastroenterol, 2012;107:303-310.l seicean a, badea r, stan-iuga r, et al. quantitative contrast-enhanced harmonic endoscopic ultrasonography for the discrimination of solid pancreatic masses. ultraschall med, 2010 ;31:571-576.kurihara,et al. eur j radiol,2012ce-e

7、us在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u ce-eus vs eus-fnal napoleon b, et al. contrast-enhanced harmonic endoscopic ultrasound in solid lesions of the pancreas: results of a pilot study. endoscopy, 2010;42(7):564-570.l作者比較35例患者行ce-eus及eus-fna診斷的情況，結(jié)果顯示ce-eus敏感性優(yōu)于eus-fna；4例eus-fna假陰性的病例，ce-eus圖像上病變?yōu)榈驮鰪?qiáng)，診斷為胰腺癌。kuri

8、hara,et al. eur j radiol,2012ce-eus在胰腺疾病診治中的應(yīng)用在胰腺疾病診治中的應(yīng)用u ce-eus vs eus-fnal kitano m, kudo m, yamao k.et al. characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmonic endoscopic ultrasonography. am j gastroenterol, 2012;107:303-310.l作者研究顯示，在胰腺癌診斷中，ce-eus并不優(yōu)于eus-fna。但