内镜超声定量弹性成像技术对胰腺良恶性病变鉴别诊断价值研究

Quantitative endoscopic ultrasound elastography in differentiation of solid pancreatic

目的探讨内镜超声定量弹性成像技术（quantitative endoscopic ultrasound elastography）在胰腺占位性病变良恶性鉴别诊断中的应用价值。方法选取2012年1-6月于中国医科大学附属盛京医院内镜诊治中心行内镜超声检查、确定有胰腺肿块且进行内镜超声定量弹性成像分析的47例患者。分别标记病变区域（A）、对照区域（B），定量弹性成像应变率比值（B／A）。胰腺肿块性质由外科手术病理结果或超声内镜引导下针吸活检结果确定。结果胰腺肿块平均直径16．8mm（9～26mm），其中34例确诊为胰腺癌，11例确诊为胰腺炎症性肿块，2例确诊为胰神经内分泌肿瘤。内镜超声定量弹性成像技术应变率比值诊断胰腺恶性肿块的敏感度、特异度分别为100％和91．7％。结论内镜超声定量弹性成像技术是区分胰腺良恶性肿块的有效方法。

Objective To investigate the value of qualitative endoscopic ultrasound （EUS） elastography in differential diag- nosis of solid pancreatic masses. Methods The study included 47 consecutive patients who underwent EUS for the evalua- tion of solid pancreatic masses between 2012 January and 2012 June. EUS elastography was performed. Representative areas from the mass （A） and soft reference areas （B） were analyzed. The result of the elastographic evaluation was defined by the quotient B/A （ strain ratio）. Final diagnosis was based on histology of surgical specimens and cytology of EUS-fine-nee- die aspiration samples. Results The mean size of the pancreatic masses was 16. 8 mm （9 - 26 mm）. The final diagnoses were pancreatic adenocarcinoma （ n = 34 ）, inflammatory mass （ n = 11 ）, malignant neuroendocrine tumor （ n -- 2 ）. The sen- sitivity and specificity of strain ratio for detecting pancreatic malignancies were 100% and 91.7%, respectively. Conclusion Quantitative, second-generation EUS elastography is useful for differential diagnosis of solid pancreatic masses.