超声内镜对胰腺小肿瘤的诊断价值

发布时间：2018-08-11 11:23

【摘要】：胰腺癌的早期诊断极为困难,多数患者确诊时均为局部进展期或已出现远处转移。直径大于2 cm的胰腺癌在诊断明确时多已有微转移发生,故早期诊断、早期手术是治愈胰腺癌的唯一手段,也是改善预后的关键。目前,体表超声、CT和MRI等临床常用的影像学诊断技术对直径小于2 cm的胰腺病变仍存在一定的漏诊率。超声内镜(endoscopic ultrasound,EUS)技术借助其高分辨率超声探头及近距离探查等优势,可提供实时的、清晰的胰腺实质回声特征,甚至可显示直径小至5 mm的胰腺病灶,被认为是诊断胰腺肿瘤最敏感的方法。近年来,随着EUS设备及技术的普及,使得胰腺实质性小肿瘤的发现率得到了提高;尤其是超声弹性成像技术(elastography)、对比增强谐波成像技术(contrast-enhanced harmonic endoscopic ultrasonography,CEH-EUS)及EUS引导下细针抽吸活组织检查(EUS-guided fine needle aspiration biopsy,EUS-FNAB)等技术的应用,进一步提高了EUS对胰腺小肿瘤的诊断与鉴别诊断的能力。
[Abstract]:The early diagnosis of pancreatic cancer is very difficult. In the case of pancreatic cancer more than 2 cm in diameter, micrometastasis often occurs when the diagnosis is definite, so early diagnosis, early operation is the only means to cure pancreatic cancer, and also the key to improve prognosis. At present, there is still a certain rate of missed diagnosis of pancreatic lesions with diameter less than 2 cm by imaging techniques such as CT and MRI. Endoscopic ultrasound endoscopy (EUS) can provide real-time and clear echogenic features of pancreatic parenchyma, and even display pancreatic lesions as small as 5 mm in diameter by virtue of its advantages such as high resolution ultrasound probe and close exploration. It is considered to be the most sensitive method for the diagnosis of pancreatic tumors. In recent years, with the popularization of EUS equipment and technology, the discovery rate of pancreatic parenchymal small tumors has been improved. Especially, the application of (elastography), contrast enhanced harmonic imaging (CEH-EUS) and EUS-guided fine needle aspiration biopsy-EUS-FNAB under the guidance of EUS has further improved the ability of EUS in diagnosis and differential diagnosis of small pancreatic tumors.
【作者单位】：复旦大学附属肿瘤医院内镜中心复旦大学上海医学院肿瘤学系;
【分类号】：R735.9

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