超声内镜对壶腹部周围病变的诊断价值研究

Diagnostic value of endoscopic ultrasonography in periampullary lesions

[目的]探讨超声内镜（endoscopicuhrasonography，EUS）对壶腹部周围病变的诊断价值。[方法]对行EUS检查诊断为壶腹周围病变的336例患者，同时接受腹部B超、腹部CT、MRI、MRCP其中一项或一项以上的检查，比较不同检查方法在壶腹周围病变中定位及定性诊断的准确率。[结果3336例中胆总管末端病变（炎症、结石、肿瘤）187例、胰头病变（炎症、肿瘤、胰腺导管内乳头状粘液瘤）86例、十二指肠乳头病变（炎症、肿瘤）33例、壶腹部病变（肿瘤）30例，分别占壶腹部周围病变的55．7％、25．6％、9．8％、8．9％。EUS的诊断准确率达92．0％，与B超、CT、MRI、MRCP比较，差异均有统计学意义（P〈O．05，x2=223．936、121．352、47．965、70．530）。[结论]EUS在壶腹部周围病变的定性、定位诊断中有重要价值。

[Objective]To explore the diagnostic value of endoscopic ultrasonography for Vater periamp- ullary lesions. [Methods]Patients with endoscopic ultrasonography examination from May 2009 to May 2014 in our hospital were analyzed retrospectively, of which 336 cases were diagnosed with periampullary lesions. These 336 patients underwent one or more of abdominal B ultrasound, abdominal CT, MRI and MRCP at the same time. The accuracy of different inspection methods in the localization and qualitative di- agnosis around Vater periampullary were compare. [Results]Among all the 336 cases,187 cases were diag- nosed with common bile duct lesions （inflammation, stones, tumor）, 86 cases were diagnosed with pancreatic head lesions（inflammation, cancer,intraductal papillary mucinous neoplasm）, 33 cases were diagnosed with duodenal papilla lesions（inflammation,tumor）and 30 cases were diagnosed with ampullary carcinoma, and they accounted for 55.7% ,25.6% ,9.8% and 8.9% of all the lesions respectively. The diagnosis accuracy of endoscopic ultrasonography was 92.0%, which was obviously superior to other imaging examinations. When compared with B ultrasound, CT, MRI and MRCP respectively, the difference was statistically signif- icant among them（all P〈0.05 ;x2= 223. 936,121. 352,223. 936,121. 352）. [Conclusion]Endoscopic ultra- sonography has important qualitative and location diagnostic value in the periampullary lesions.