胰腺体尾部肿瘤超声诊断的临床观察

Clinical observation of ultrasonography in diagnosis of pancreatic mass in body and tail

目的:探讨超声对胰腺体尾部肿瘤的诊断价值。方法:回顾性分析21例经常规超声或术中超声检查诊断为胰腺体尾部肿瘤的图像特点,并与手术及病理结果相对照。图像分析的主要内容有肿瘤回声、境界、形态以及毗邻关系等。结果:21例患者中,术前超声诊断:(1)基本符合11例(52·4%);(2)漏诊3例(14·3%),为2例胰岛细胞瘤及1例胰体尾癌;(3)误诊7例(33·3%),其中3例胃间质肿瘤、1例炎性包块误诊为胰腺癌,1例全胰癌误诊为胰体尾癌,另2例将胰腺肿瘤与腹腔或腹膜后肿瘤相混淆。结论:超声具有安全、无创、简便的优势,是胰腺体尾部肿瘤首选的诊断方法,在临床上有着重要的应用价值,结合CT和磁共振等检查,可提高诊断准确率。

Objective：To investigate the value of the clinical application of uhrasonography in the diagnosis of mass in pancreatic body and tail. Materials and Methods：We retrospectively analyzed 21 cases that were diagnosed as mass of pancreatic body and tail by transabdominal and intraoperative uhrasonography. We compared the features of the mass with the results of operations and pathology. The analysis of the image was focused on the echogenic edge, morphologic change and the periphery of the mass. Results：In the 21 cases, the ultrasound diagnosis rate was 52.4% （ 11/21 ） , and 3 cases were failed to be diagnosed, including 2 cases of insulinoma and 1 case of carcinoma of pancreatic tail. The missed diagnosis rate was 33.3% （7/21） , including 3 cases of gastrointestinal stromal tumor, 1 case of inflammatory pesudotumor, 1 case of carcinoma of whole pancreas, and 2 cases were confused with the tumor of the abdominal cavity and post peritoneum. Conclusion： Uhrasonography may be used as the first selective method to detect mass in pancreatic body and tail due to its many merits, such as safe, non-invasive,convenient and so on. It is valuable in the clinical application. The combination of CT and MRI can raise the diagnosis rate and help surgical treatment.