Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer

瞄准：作为基于微容器的灌注特征把发炎区分开来与胰腺的癌的一个方法评估提高对比的 endosonography。方法：在有怀疑的慢性胰炎的 86 个病人(变老：62+/-12 年；性别：f/m 38/48 ) ，胰腺的损害被常规内视镜的 B 模式，力量 Doppler 超声和提高对比的力量模式检验(日立 EUB 525， SonoVue， 2.4 mL， Bracco ) 用为恶意的损害的下列标准：用常规力量 Doppler 的没有可检测的 vascularisation 在用 SonoVue 提高对比的技术和没有可检测的静脉的容器里面的短距离上的动脉的容器的扫描、不规则的外观损害。如果所有标准是可检测的，恶意的损害被假定[内视镜的超声(EUS ) 指导了的标准答案好针渴望细胞学，操作] 。没有瘤形成的慢性胰炎的标准在 SonoVue 的注射前被定义为没有可检测的 vascularisation，在在 SonoVue 的注射和动脉、静脉的容器的察觉以后的至少 20 公里的距离上的容器的常规外观。结果：常规 EUS 的敏感和特性为胰腺的癌症分别地是 73.2% 和 83.3% 。与恶意的胰腺的损害和特性在 56 个病人中的 51 个增加到 91.1% 的提高对比的 EUS 的敏感与长期的煽动性的胰腺的疾病在 30 个病人中的 28 个增加了到 93.3% 。结论：提高对比的内视镜的超声改进在慢性胰炎和胰腺的癌之间的区别。

AIM： To evaluate the contrast-enhanced endosonography as a method of differentiating inflammation from pancreatic carcinoma based on perfusion characteristics of microvessels. METHODS： In 86 patients with suspected chronic pancreatitis （age： 62± 12 years; sex： f/m 38/48）, pancreatic lesions were examined by conventional endo- scopic B-mode, power Doppler ultrasound and contrastenhanced power mode （Hitachi EUB 525, SonoVue, 2.4 mL, Bracco） using the following criteria for malignant lesions： no detectable vascularisation using conventional power Doppler scanning, irregular appearance of arterial vessels over a short distance using SonoVue contrastenhanced technique and no detectable venous vessels inside the lesion. A malignant lesion was assumed if all criteria were detectable [gold standard endoscopic ultrasound （EUS）-guided fine needle aspiration cytology, operation]. The criteria of chronic pancreatitis without neoplasia were defined as no detectable vascularisation before injection of SonoVue, regular appearance of vessels over a distance of at least 20 mm after injection of SonoVue and detection of arterial and venous vessels. RESULTS： The sensitivity and specifidty of conventional EUS were 73.2% and 83.3% respectively for pancreatic cancer. The sensitivity of contrast-enhanced EUS increased to 91.1% in 51 of 56 patients with malignant pancreatic lesion and the specificity increased to 93.3% in 28 of 30 patients with chronic inflammatory pancreatic disease.CONCLUSION： Contrast-enhanced endoscopic ultrasound improves the differentiation between chronic pancreatitis and pancreatic carcinoma.