Becker D, Strobel D, Bernatik T, Hahn E G
Department of Medicine I, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Gastrointest Endosc. 2001 Jun;53(7):784-9. doi: 10.1067/mge.2001.115007.
EUS is a precise method for detection and staging of pancreatic tumors. However, differentiation between inflammatory pseudotumor and pancreatic carcinoma remains difficult. The aim of this study was to evaluate contrast-enhanced EUS as a method of differentiating inflammation and carcinoma based on perfusion characteristics.
Patients with solid pancreatic masses underwent EUS with a linear echoendoscope. Perfusion in the pancreatic tissue and the mass was assessed with native and contrast-enhanced EUS with power- and color-Doppler imaging. Examinations were evaluated by a blinded reader. A markedly hyperperfused lesion was considered an inflammatory pseudotumor whereas lesions that were hypoperfused compared with surrounding tissue were considered to be carcinoma.
Fifteen of 23 patients had hypoperfusion within the mass and 8 patients had hyperperfused lesions. Of the 15 patients with hypoperfused masses, all had pancreatic adenocarcinoma; 1 of 8 patients with a hyperperfused lesion also had adenocarcinoma. The remaining 7 patients had focal inflammation. Sensitivity for differentiation of pancreatic carcinoma versus inflammatory changes was 94%, specificity 100%.
Echo-enhanced power-Doppler EUS reliably differentiates pancreatic neoplasm and focal pancreatitis. The diagnostic accuracy of this technique is comparable to CT, magnetic resonance imaging, positron emission tomography, and ERCP.
超声内镜检查（EUS）是检测胰腺肿瘤及进行分期的一种精确方法。然而，炎症性假瘤与胰腺癌之间的鉴别仍存在困难。本研究的目的是评估对比增强超声内镜检查作为一种基于灌注特征来鉴别炎症与癌的方法。
患有实性胰腺肿块的患者接受了使用线性超声内镜的超声内镜检查。通过常规及对比增强超声内镜检查，利用能量多普勒成像和彩色多普勒成像评估胰腺组织及肿块内的灌注情况。由一位不知情的阅片者对检查结果进行评估。灌注明显增强的病变被视为炎症性假瘤，而与周围组织相比灌注减少的病变则被视为癌。
23例患者中，15例肿块内存在灌注减少，8例患者有灌注增强的病变。在15例灌注减少的肿块患者中，均为胰腺腺癌；8例灌注增强病变的患者中有1例也为腺癌。其余7例患者为局灶性炎症。胰腺癌与炎症性改变鉴别的敏感性为94%，特异性为100%。
超声增强能量多普勒超声内镜检查能够可靠地鉴别胰腺肿瘤与局灶性胰腺炎。该技术的诊断准确性与计算机断层扫描（CT）..、磁共振成像、正电子发射断层扫描及内镜逆行胰胆管造影（ERCP）相当。
原文中“CT, magnetic resonance imaging, positron emission tomography, and ERCP”后的内容不完整，翻译时保留了原文格式。
