胰腺转移性肿瘤的超声诊断

Ultrasonographic Findings for Pancreatic Secondaries

复习１８例经病理学、细胞学或诊断性治疗证实的胰腺转移瘤病人的超声诊断。在声像图上，肿瘤通常表现为低回声，后方回声无变化或增强，边界较清楚但不规则，胰头病灶可导致胆总管和胰管的扩张；邻近血管受压、显示不清或消失，或肿物与血管的分界不清。胰腺转移瘤虽然较为少见，但早期发现较难。在与原发性胰腺癌进行鉴别时，应结合病人原发肿瘤的存在，肿块边界清楚，行超声引导针吸活检，从而作出正确的诊断。

We reviewed 18 patients with pancreatic metastases(PMs) which were examined suprasonically and then verified by pathology(n=7), cytology(n=10), or diagnostic chemotherapy(n=1). On the sonogram PMs usually presented ashypoechoic fool(20/20 ), well-defined(14/20) or irregular (19/20) margin, binary dict (2/5 foci in pancreatic head) and pancreatic duct (3/5 in the head and 1/11 in the body) obstrution, and abnormal changes of the vein near the tumor (11/16 evaluated fool), without posterior sound transmission or shadowing (14/20). Although PMs isan infrequent occurrence, it is more difficult to be detected an at earlier stage or to be differentiated from primary malignancies of the pancreas. However,the pre-existing primary lesion, the definitive margin of tumors on sonograms, and the ultrasound-guided biopsy are helpful in making the diagnosis.