Lai R, Freeman M L, Cass O W, Mallery S
Dept. of Internal Medicine, Division of Gastroenterology, Hennepin County Medical Center, University of Minnesota, Minneapolis, Minnesota, USA.
Endoscopy. 2004 Aug;36(8):705-9. doi: 10.1055/s-2004-825663.
During linear-array endoscopic ultrasonography (EUS), the main pancreatic duct can be followed continuously from the major papilla into the pancreatic body in most patients. Often, the duct can also be seen crossing a sonographic border between the ventral and dorsal pancreatic anlagen. It was hypothesized that the presence of either feature excludes pancreas divisum, whereas the absence of these features suggests complete pancreas divisum.
Pancreas divisum was sought during all linear-array EUS examinations conducted between July 1999 and June 2003. Charts were reviewed retrospectively, and patients who underwent endoscopic retrograde pancreatography after, but not before, EUS were included in the study.
A total of 162 patients had EUS before ERCP. Adequate evaluation of the pancreatic duct was possible in 78 % of the patients. The prevalence of pancreas divisum was 13.6 %. In patients with adequate duct visualization, the sensitivity, specificity, and positive and negative predictive values for EUS were 95 %, 97 %, 86 %, and 99 %, respectively. The overall accuracy of EUS for identifying pancreas divisum was 97 % in this subgroup.
Adequate EUS evaluation of pancreas divisum was possible in most cases. Linear-array EUS is a promising diagnostic test for pancreas divisum.
在进行线阵内镜超声检查（EUS）时，多数患者的主胰管可从主乳头开始连续追踪至胰体部。通常，还可看到该导管穿过胰腺腹侧和背侧原基之间的超声边界。据推测，出现上述任何一种特征可排除胰腺分裂症，而无这些特征则提示完全性胰腺分裂症。
在1999年7月至2003年6月间进行的所有线阵EUS检查中查找胰腺分裂症。回顾性查阅病历，将在EUS检查之后而非之前接受内镜逆行胰胆管造影术的患者纳入研究。
共有162例患者在ERCP之前接受了EUS检查。78%的患者能够对胰管进行充分评估。胰腺分裂症的患病率为13.6%。在胰管显示充分的患者中，EUS的敏感度、特异度、阳性预测值和阴性预测值分别为95%、97%、86%和99%。在该亚组中，EUS识别胰腺分裂症的总体准确率为97%。
多数情况下可通过EUS对胰腺分裂症进行充分评估。线阵EUS是一种有前景的胰腺分裂症诊断检查方法。
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