内镜超声检查对胰头部肿块的诊断价值

Value of endoscopic ultrasonography in diagnozing the pancreatic head mass

胰头部肿块常见病因主要有胰腺癌、囊性病变、炎性病变、神经内分泌肿瘤等,传统的影像学检查诊断价值有限。内镜超声检查采用高频超声近距离扫查技术,可以清晰显示病变局部细节,在内镜超声实时引导下行细针穿刺取材可获取病理组织学和细胞学诊断。目前认为内镜超声在胰腺癌早期检出的敏感性和术前评价局部进展的准确性等方面优于与其他影像学检查方法。肿块性慢性胰腺炎和肿块性自身免疫性胰腺炎、胰头囊性肿块在内镜超声下有特殊的声像图特征可行诊断。内镜超声对于胰腺神经内分泌肿瘤不仅可以准确定位,还可以取材检查,从而能够术前明确诊断。大量证据表明内镜超声检查对胰头肿块诊断具有较高的准确性和特异性。

Common etiologies of .pancreatic head mass include carcinoma,cystic lesions,inflammatory lesions and neuroendocrine tumours,etc. The value of traditional imaging modalities in diagnozing pancreatic head mass is limited. Using high frequency and short distance scanning teehniqes, endoscopic ultrasound （EUS） can show the details of the mass. And also EUS-guided fine needle aspirations can acquire the specimen and establish pathological and cytologic diagnosis. Presently,EUS is prior to other imaging modalities in early diagnosis and preoperative evaluation of pancreatic carcinoma. There are special EUS features for chronic pancreatitis mass, autoimmune pancreatitis mass and cystic mass. EUS can also localize the pancreatic endocrine tumours accurately and acquire specimen preoperatively. A large amount of evidence confirmed that EUS had high accuracy and specificity in diagnozing pancreatic head mass.