壶腹周围病变超声内镜诊断价值的探讨

Endoscopic Ultrasonography in Diagnosis of Periampullary Diseases

目的 探讨超声内镜 (EUS)对壶腹周围病变的诊断价值。 方法 对 5 6例壶腹周围病变患者 (肿瘤性病变 44例 ,非肿瘤性病变 12例 )施行超声内镜检查 ,并与体外超声 (US)、CT检查比较。 结果 对照手术结果 ,EUS对肿瘤性病变正确诊断率为 88.6 %( 39 4 4 ) ,漏诊 3例 ,误诊 2例 ;非肿瘤性病变正确诊断率 83.3%( 10 12 ) ,误诊 2例。EUS对全部病例的诊断符合率为 87.5 %( 4 9 5 6 ) ,US与CT分别为 5 3.6 %( 30 5 6 )与 46 .4%( 2 6 5 6 ) ,有显著差异 (P =0 .0 11)。 结论 EUS是诊断壶腹周围病变的良好手段 ,特别是对小病变有显著的优越性。

Objective To investigate the value of endoscopic ultrasonography (EUS) in the diagnosis of periampullary diseases. Methods 56 patients with periampullary diseases were examined by EUS. Of the 56 cases, 44 were diagnosed as tumors, 12 belonged to non-tumor category. Result As compared with the postoperative pathological diagnosis, the accuracy of EUS diagnosis for tumors was 88.6% (39/44) with misdiagnosis in 2 cases and it failed to detect the tumors in 3 cases. The accuracy of diagnosis for no-tumor diseases was 83.3% (10/12). The total diagnosis accordance rate of EUS was 87.5%, that was higher than 53.5% of the US diagnosis and 46.4% of the CT diagnosis. Conclusion EUS helps to make an accurate preoperative diagnosis especially for small tumors and benign diseases of periamapullary region.