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| 1 | 造影增强超声内镜检查对胰腺占位病变的鉴别诊断初步探讨显示文摘目的探讨造影增强EUS在胰腺占位病变鉴别诊断中的应用价值。方法选择18例临床疑有胰腺占位病变或慢性胰腺炎的患者为检查对象,以内镜超声引导下细针穿刺细胞和(或)组织病理学结果为最终诊断,另选择5例正常胰腺作为对照,观察不同胰腺组织造影增强EUS检查下目标区域形态、内部回声及血流灌注的增强特征。结果造影增强EUS显示,5例正常胰腺实质呈均匀分布的点状或棒状彩色血流信号(Ⅰ、Ⅱ型);而2例慢性胰腺炎患者的胰腺实质呈棒状或斑块状彩色血流信号,且分布不均匀(Ⅱ、Ⅲ型)。13例胰腺癌病变内部均呈少量点状或棒状增强(Ⅰ、Ⅱ型),部分肿块伴周边局部增强血流信号,且大部分呈慢进快退型;而3例胰腺良性占位胰岛细胞瘤病灶内部则呈整体斑块状明显增强(Ⅲ型),其中有2例呈快进快退型。此外,正常胰腺及各类胰腺疾.病的增强强度也呈不同等级。结论造影增强EUS诊断技术安全、可行,正常胰腺及不同胰腺疾病之间可显示不同的增强模式、时相特点及增强强度分级,为胰腺病变的鉴别诊断提供了一种新的影像学手段。 | 诸琦 熊慧芳 徐凯 贺益萍 陈希 谭继宏 夏璐 | 2008 | 中华消化内镜杂志2008，25，3： | 24 |
| 2 | 超声造影在胰腺囊实性病变鉴别诊断中的应用价值显示文摘目的 探讨超声造影鉴别诊断胰腺囊实性病变的临床应用价值.方法 对88例胰腺囊实性病变患者行常规超声和超声造影检查,由两位不同年资超声医师独立阅片,应用ROC曲线评估常规超声和超声造影判断胰腺囊实性病变良恶性的诊断价值,Kappa值评估不同年资超声医师之间的一致性.结果 90个病灶中胰腺囊肿5个,胰腺假性囊肿14个,胰腺浆液性囊腺瘤14个,胰腺黏液性囊腺瘤11个,胰腺癌合并液化13个,胰腺实性假乳头状瘤12个,慢性胰腺炎11个,胰腺导管内乳头状瘤2个,胰腺神经内分泌瘤3个,胰腺囊腺癌、成人胰母细胞瘤、胰腺淋巴瘤、胰腺肉瘤样癌、胰腺神经内分泌癌各1个.常规超声和超声造影对具体病变的正确诊断率在年资高者为36.7%和65.5%(P<0.05),在年资低者为20.0%和53.3%(P<0.05).受试者之间的一致性超声造影较常规超声高,Kappa值分别为0.654±0.095和0.464±0.075.年资低者和年资高者ROC曲线下面积在常规超声为0.670和0.832,在超声造影为0.902和0.919.结论 与常规超声比较,超声造影能显著提高胰腺囊实性病变的鉴别诊断率. | 徐明 徐作峰 沈顺利 周路遥 王伟 黄光亮 潘福顺 谢晓燕 吕明德 | 2014 | 中华超声影像学杂志2014，23，10： | 15 |
| 3 | Utility of PET/CT in diagnosis, staging, assessment of resectability and metabolic response of pancreatic cancer显示文摘Pancreatic cancer is one of the most common gastrointestinal tumors, with its incidence staying at a high level in both the United States and China. However, the overall 5-year survival rate of pancreatic cancer is still extremely low. Surgery remains the only potential chance for long-term survival. Early diagnosis and precise staging are crucial to make proper clinical decision for surgery candidates. Despite advances in diagnostictechnology such as computed tomography(CT)and endoscopic ultrasound,diagnosis,staging and monitoring of the metabolic response remain a challenge for this devastating disease.Positron emission tomography/CT(PET/CT),a relatively novel modality,combines metabolic detection with anatomic information.It has been widely used in oncology and achieves good results in breast cancer,lung cancer and lymphoma.Its utilization in pancreatic cancer has also been widely accepted.However,the value of PET/CT in pancreatic disease is still controversial.Will PET/CT change the treatment strategy for potential surgery candidates?What kind of patients benefits most from this exam?In this review,we focus on the utility of PET/CT in diagnosis,staging,and assessment of resectability of pancreatic cancer.In addition,its ability to monitor metabolic response and recurrence after treatment will be emphasis of discussion.We hope to provide answers to the questions above,which clinicians care most about. | Xiao-Yi Wang Feng Yang Chen Jin De-Liang Fu | 2014 | World Journal of Gastroenterology2014，20，42： | 13 |
| 4 | 超声造影对胰腺假性囊肿、囊腺瘤及囊腺癌鉴别诊断的价值显示文摘目的探讨超声造影鉴别诊断胰腺假性囊肿、囊腺瘤及囊腺癌的价值。方法回顾性分析2005年2月至2010年8月在我院接受常规超声和超声造影检查的31例胰腺囊性病变患者的临床资料,总结其常规超声和超声造影的图像特点,比较两者在胰腺囊性病变诊断中的价值。结果共发现32个病灶,其中胰腺假性囊肿18个,胰腺囊腺瘤9个,胰腺囊腺癌5个。常规超声及超声造影对胰腺囊性病变的诊断正确率分别为50.0%(16/32)、75.0%(24/32),其差异具有统计学意义(P=0.039)。超声造影在胰腺囊性病变中对胰腺假性囊肿诊断价值最高(Youden指数最高),与本研究诊断标准比较其诊断一致性符合率也最好(Kappa值为0.814)。结论与常规超声比较,超声造影能显著提高胰腺囊性病变的诊断准确率。 | 徐明 谢晓燕 徐辉雄 徐作峰 刘广健 郑艳玲 陈沛芬 吕明德 | 2011 | 中华医学超声杂志(电子版)2011，8，3： | 12 |
| 5 | Diagnosis of pancreatic tumors by endoscopic ultrasonography显示文摘Pancreatic tumors are highly diverse, as they can be solid or cystic, and benign or malignant. Since their imaging features overlap considerably, it is often difficult to characterize these tumors. In addition, small pancreatic tumors, especially those less than 2 cm in diameter, are difficult to detect and diagnose. For characterizing pancreatic tumors and detecting small pancreatic tumors, endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available. This technique also provides good results in terms of the preoperative staging of pancreatic tumors. EUS-guided fine needle aspiration (EUS-FNA) has also proved to be a safe and useful method for tissue sampling of pancreatic tumors. Despite these advantages, however, it is still difficult to differentiate between be-nign and malignant, solid or cystic pancreatic tumors, malignant neoplasms, and chronic pancreatitis using EUS, even when EUS-FNA is performed. Recently, contrast-enhanced EUS with Doppler mode (CE-EUS) employing ultrasound contrast agents, which indicate vascularization in pancreatic lesions, has been found to be useful in the differential diagnosis of pancreatic tumors, especially small pancreatic tumors. However, Doppler ultrasonography with contrast-enhancement has several limitations, including blooming artifacts, poor spatial resolution, and low sensitivity to slow flow. Consequently, an echoendoscope was developed recently that has a broad-band transducer and an imaging mode that was designed specifically for contrastenhanced harmonic EUS (CEH-EUS) with a secondgeneration ultrasound contrast agent. The CEH-EUS technique is expected to improve the differential diagnosis of pancreatic disease in the future. This review describes the EUS appearances of common solid and cystic pancreatic masses, the diagnostic accuracy of EUS-FNA, and the relative efficacies and advantages of CE-EUS and CEH-EUS along with their relative advantages and their complementary roles in clinical practice. | Hiroki Sakamoto Masayuki Kitano Ken Kamata Muhammad El-Masry Masatoshi Kudo | 2010 | World Journal of Radiology2010，2，4： | 11 |
| 6 | 造影增强超声内镜对上消化道及毗邻占位的诊断价值显示文摘目的探讨造影增强超声内镜(CE-EUS)对上消化道及毗邻占位的诊断价值。方法收集广西医科大学第一附属医院2014年6月至2015年3月收治的上消化道及毗邻占位性病变180例,均进行CE-EUS检查,通过观察实性占位的血流灌注增强特征作出初步诊断,并与超声内镜引导下细针穿刺细胞学(EUS-FNA)和(或)组织病理学结果、胆道刷检细胞学涂片结果、手术病理结果、CT、磁共振成像(MRI)及随访结果的综合判断结果进行对比分析,全面总结分析各实性占位内镜超声造影特点。结果180例上消化道及毗邻占位中,CE-EUS与最终诊断符合169例,不符合11例,诊断符合率为93.9%。结论 CE-EUS可引导EUS-FNA穿刺,提高EUS-FNA阳性率。 | 邓巍 姜海行 覃山羽 | 2017 | 重庆医学2017，46，14： | 8 |
| 7 | 胰腺疾病四种影像学检查技术的对比分析显示文摘目的评估二维超声、平扫CT、超声造影、增强CT4种影像学检查技术在胰腺疾病定位、定性诊断中的价值。方法回顾性对比分析经病理证实的44例(45个病灶)胰腺局灶性病变患者的二维超声、平扫CT的表现,并研究超声造影和增强CT在不同时相的增强模式及灌注特点。结果45个病灶中,恶性病灶29个,良性病灶16个,与二维超声及平扫CT相比,超声造影和增强CT具有较高的诊断价值。二维超声对恶性胰腺占位性病变诊断的敏感性、特异性、准确性分别为72.41%、62.50%和66.67%;平扫CT对恶性胰腺占位性病变诊断的敏感性、特异性、准确性分别为68.97%、75.00%和68.89%;超声造影对恶性胰腺占位性病变诊断的敏感性、特异性、准确性分别为93.10%、87.50%和91.11%;增强CT对恶性胰腺占位性病变诊断的敏感性、特异性、准确性分别为86.21%、93.75%和86.67%。超声造影和增强CT两种方法诊断胰腺占位性病变的差异无统计学意义(P〉0.05)。结论与二维超声及平扫CT相比,超声造影和增强CT检查对胰腺占位性病变均具有较高的诊断符合率,超声造影是继增强CT之后又一项诊断胰腺占位性病变的新技术。 | 王琦 李甜甜 张羽 王秀云 杨秀华 | 2012 | 中华超声影像学杂志2012，21，10： | 4 |
| 8 | 增强CT、超声造影和增强MRI对胰腺占位性病变性质的诊断价值比较显示文摘目的比较增强CT、超声造影和增强MRI对胰腺占位性病变性质的诊断价值。方法回顾性分析80例胰腺占位性病变并行手术治疗患者的临床资料,以及患者术前影像学检查结果。以术后病理检查结果作为“金标准”,比较增强CT、超声造影及增强MRI鉴别胰腺占位性病变良恶性的价值。结果80例患者经病理检查共发现80个病灶,其中18个为良性病变,62个为恶性病变。增强CT诊断胰腺病变良恶性的敏感度、特异度、阳性预测值、阴性预测值分别为89.8%、72.2%、89.8%、72.2%;超声造影的上述四个指标依次为86.8%、71.4%、89.2%、66.7%;增强MRI的上述四个指标依次为82.8%、63.6%、85.7%、58.3%。增强CT、超声造影和增强MRI对胰腺占位性病变良恶性的诊断效能差异无统计学意义(P>0.05)。采用超声造影联合增强CT或增强MRI诊断胰腺占位性病变性质的受试者工作特征曲线下面积大于仅仅应用其中一种检查方法。结论增强CT、超声造影和增强MRI对胰腺占位性病变良恶性的诊断效果相似,采用超声造影联合增强CT或增强MRI有助于提高诊断的准确性。 | 黄滔 方程 郭兵 舒强 苏松 李波 | 2019 | 广西医学2019，41，19： | 4 |
| 9 | 胰腺囊性肿瘤术前良恶性判断显示文摘随着影像诊断技术的广泛应用和改进,胰腺囊性肿瘤(PCN)的诊断率不断增加。常见的胰腺囊性肿瘤包括浆液性囊腺瘤(SCN)、黏液性囊腺瘤(MCN)和导管内乳头状黏液性肿瘤(IPMN)以及囊实性假乳头状肿瘤(SPN),一旦怀疑为恶性时,均应行根治性手术切除。PCN的术前诊断和良恶性判断十分重要,目前主要依靠临床表现、影像学检查和实验室检查。当临床发现老年男性病人、血清肿瘤标记物CA19-9升高、伴有巨大胰腺肿块、体重下降、有特征性影像学表现者,应考虑恶性肿瘤的可能。主要依靠术后病理、经超声内镜下囊液抽取分析和穿刺组织活检确诊,包括肿瘤相关DNA、MicroRNA和蛋白质标记物的分析。 | 傅德良 | 2013 | 中国实用外科杂志2013，33，6： | 1 |
| 10 | 六氟化硫微泡在超声诊断胰腺疾病中的应用显示文摘胰腺肿瘤的早期诊断一直是困扰医学界的难题,大多胰腺肿瘤患者发现时已属晚期。随着各种医学影像技术的发展.目前对胰腺微小病变的检出已成为可能,但临床对肿块性质的鉴别仍存在一定困难。由于胰腺为乏血供脏器,包括经腹超声(transabdominal sonograph,TAS)及内镜超声检查(endoscopic ultrasonography, EUS)的超声(US)检查中,大多胰腺肿块均呈低回声改变,因此单纯的回声表现并无鉴别诊断意义,实际诊断准确率不高。 | 熊慧芳 诸琦 | 2008 | 诊断学理论与实践2008，7，6： | 0 |
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