超声内镜对壶腹癌的诊断价值

THE VALUE OF ENDOSCOPIC ULTRASONOGRAPHY IN THE DIAGNOSIS OF AMPULLARY CAR-CINOMA

报告超声内镜（ＥＵＳ）对１４例壶腹癌的诊断正确率、图象特征及术前进展度的诊断。结果表明：①ＥＵＳ对壶腹癌的病灶显示率为１００．０％，诊断正确率为７８．６％，高于体表超声和ＣＴ（Ｐ＜０．０５），与逆行胰胆管造影（ＥＲＣＰ）相似（Ｐ＞０．０５）。②壶腹癌ＥＵＳ表现呈低回声占８１．８％，高回声占１８．２％。③ＥＵＳ对术前壶腹癌的十二指肠壁、胆总管、胰管、胰头的浸润以及淋巴结转移诊断的正确率分别为８３．３％，６６．７％，５０．０％，３３．３％和１００．０％。

The value of endoscopic ultrasonography(EUS)for diagnosing a mpullary carcinoma was assessed in14 patients。 The diagnostic accuracy,the chariacteristics of the images and the preoperative invasion of thecarcinoma were studied. The results showed that:(1)The lesions were clearly demonstrated in all cases(100.0%)and the diagnostic accuracy of EUS was 78.6%,which was better than that of transabdominalultrasonography and CT (P < 0. 05 ), but similar to that of endoscopic retrograde cholangio-pancreato-graphy( ERCP)(P>0.05).Three patients with pancreatic carcinoma were misdiagnosed as ampullarycarcinoma by EUS, because the carcinoma was situated at the head of the pancreas and infiltrated to theduodenal wall.(2)Hyperecho image was obtained in 81.8%of the cases and hypoecho image in 18. 2%ofthe cases.(3)The accuracy of EUS in demonstrating the invasion of the carcinoma into the duodenal wall,common bile duct, pancreatic duct and the head of the pancreas was 83.3%;66.7%, 50. 0%and 33.3%respectively and the lymph node matastasis of the carcinoma was 100.0%。