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胆胰管内超声内镜对胰腺疾病的诊断价值
孙畅,潘雪,金震东*,李兆申*,刘枫,金震东*,李兆申*
0
(第二军医大学长海医院消化内科,上海 200433)
摘要:
目的评估胆胰管内超声内镜检查(IDUS)在胰腺疾病中的诊断价值。方法回顾分析2005年2月至2010年2月间行IDUS的63例胰腺疾病患者的影像学资料,IDUS均在经内镜逆行胰胆管造影(ERCP)时用经导丝的UMG20-29R腔内超声探头扫查胰腺。比较IDUS与CT、MRI、超声内镜(EUS)及腹部B超等5种方法在诊断胰腺疾病中的区别,以进一步评估IDUS在胰腺疾病的临床诊断中的应用价值。结果IDUS对慢性胰腺炎(23例)、胰腺癌(10例)、导管内乳头状黏液瘤(IPMT,25例)、胰腺囊腺瘤(4例)的诊断准确率和Kappa检测值分别为93.7%(59/63),0.854;100.0%(63/63),1.00;90.5%(57/63),0.898以及96.8%(61/63),0.848。IDUS诊断准确率和Kappa检测值均优于其他4种方法,并且对1例胰腺囊腺癌也做出正确的术前诊断。结论IDUS对胰腺疾病的诊断有较高的应用价值。
关键词:  胆胰管内超声内镜检查  慢性胰腺炎  胰腺肿瘤  导管内乳头状黏液瘤  胰腺囊腺瘤  胰腺囊腺癌
DOI:10.3724/SP.J.1008.2010.0756
投稿时间:2010-03-23修订日期:2010-04-26
基金项目:
Diagnosis value of intraductal ultrasonography for pancreatic diseases
SUN Chang, PAN Xue, JIN Zhendong*, LI Zhaoshen*, LIU Feng,JIN Zhen-dong*, LI Zhao-shen*
(Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China)
Abstract:
tive To evaluate the value of intraductal ultrasonography (IDUS) in diagnosis of pancreatic diseases.MethodsWe retrospectively reviewed the imaging data of 63 patients with pancreatic diseases who underwent IDUS from February 2005 to February 2010.A 20 MHz over-the-guidewire intraductal US catheter probe was used during endoscopic retrograde cholangio-pancreatography(ERCP) for further examination of the pancreas.We also compared the results of CT, magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) and abdominal ultrasonography in diagnosis of pancreatic diseases, so as to further evaluate the value of IDUS in the clinical diagnosis of pancreatic diseases.ResultsThe accuracies of IDUS in diagnosis of chronic pancreatitis (23 cases), pancreatic cancer (10 cases), intraductal papillary mucinous tumors (IPMT, 25 cases), and pancreatic adenoma (4 cases) were 93.7% (59/63), 100.0% (63/63), 90.5% (57/63), and 96.8% (61/63), and the Kappa values were 0.854, 1.00, 0.898, and 0.848, respectively.The diagnostic accuracies and Kappa test values of IDUS were better than those of the other four methods.IDUS correctly diagnosed the pancreatic cystadenocarcinoma in one patient before operation.ConclusionIDUS has a high diagnostic value for pancreatic diseases.
Key words:  intraductal ultrasonography  chronic pancreatitis  pancreatic cancer  intraductal papillary mucinous tumors  pancreatic adenoma  pancreatic cystadenocarcinoma