超声造影对胰腺假性囊肿、囊腺瘤及囊腺癌的鉴别诊断价值

Clincal value of contrast - enhanced ultrasound in differential diagnosis of pancreatic pseudocysts, cystadenomas and cystadenocarcinomas

目的探讨超声造影（CEUS）在胰腺假性囊肿、囊腺瘤及囊腺癌的鉴别诊断价值，以提高该病的诊断水平。方法回顾性分析对71例胰腺囊性病变患者的常规超声及CEUS图像表现，并与手术或病理结果进行比较，评估两种方法的定性诊断能力。结果71例胰腺囊性病变中，胰腺假性囊肿32、囊腺瘤24例，囊腺癌15例；CEUS在胰腺假性囊肿、胰腺囊腺癌诊断的灵敏度、准确性分别为84．4％、93．0％和86．7％、88．7％，均显著高于常规超声56．3％、80．3％和53．3％、74．6％（x2=6．06、4．92、3．97、4．71，均P〈0．05）。结论胰腺假性囊肿、囊腺瘤与囊腺癌在影像学表现方面存在一定相似之处，常规超声结合CEUS有助于提高胰腺囊性病变的定性诊断及鉴别诊断能力。

Objective To investigate the value of contrast - enhanced ultrasound （CEUS） in differential diagnosis of pancreatic pseudocysts, cystadenomas and cystade , so as to improve diagnostic accuracy of the condition. Methods The results of CEUS and conventional ultrasound for 71 patients with pancreatic cystic lesions were analyzed retrospectively, and compared with the finally obtained surgical - pathological examination to assess the ability of qualitative diagnosis between two methods. Results In 71 pancreatic cystic lesions, tilere were 32 pancreatic pseudocysts ,24 cystadenomas and 15 cystadenocarcinomas. The sensitivity and accuracy of CEUS for pancreatic pseudocysts and cystadenocarcinomas were 84.4% ,93.0% and 86.7% ,88.7% ,which were higher than those of conventional ultrasound 56.3 % , 80.3 % and 53.3 % ,74.6 % （ X2 = 6.06,4.92,3.97,4.71, all P 〈 0.05 ）. Conclusion There are some similarities in terms of imaging manifestations among pancreatic pseudocysts, cystadenomas and cystadenocarcinomas. Combining conventional ultrasound with CEUS can help the differential diagnosis of pancreatic cystic lesions.