Kwon Richard S, Brugge William R
Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Curr Opin Gastroenterol. 2005 Sep;21(5):561-7. doi: 10.1097/01.mog.0000174223.74783.1b.
Exciting new developments and applications of imaging techniques in pancreatic diseases have emerged. This review discusses these new advances and how they are improving our ability to diagnose malignancies and inflammatory lesions, to grade severity of pancreatitis, and to stage pancreatic cancer accurately.
A new computed tomography severity index shows promise for grading the severity of acute pancreatitis. Magnetic resonance imaging is comparable with computed tomography in staging acute pancreatitis. Analysis of pancreatograms and textural changes of the parenchyma may prove helpful in diagnosing chronic pancreatitis. Contrast enhanced ultrasonography may prove to be a useful way to judge the degree of inflammation and fibrosis in autoimmune pancreatitis and to monitor response to steroid therapy. The debate over the best means of staging pancreatic cancer has focused on endoscopic ultrasound and computed tomography. Preliminary studies with contrast enhanced ultrasonography report improved diagnostic and staging capabilities with pancreatic cystic and solid neoplasms. Improvements in positron emission tomography/computed tomography scans may improve the detection of neuroendocrine tumors.
These new advances will help refine the diagnosis and staging of pancreatic diseases.
胰腺疾病成像技术出现了令人兴奋的新进展和应用。本综述讨论了这些新进展以及它们如何提高我们诊断恶性肿瘤和炎性病变、评估胰腺炎严重程度以及准确分期胰腺癌的能力。
一种新的计算机断层扫描严重指数在评估急性胰腺炎严重程度方面显示出前景。磁共振成像在急性胰腺炎分期方面与计算机断层扫描相当。胰管造影分析和实质纹理变化可能有助于诊断慢性胰腺炎。对比增强超声检查可能是判断自身免疫性胰腺炎炎症和纤维化程度以及监测类固醇治疗反应的有用方法。关于胰腺癌最佳分期方法的争论集中在内镜超声和计算机断层扫描上。对比增强超声检查的初步研究报告称，其在胰腺囊性和实性肿瘤的诊断和分期能力有所提高。正电子发射断层扫描/计算机断层扫描的改进可能会提高神经内分泌肿瘤的检测率。
这些新进展将有助于完善胰腺疾病的诊断和分期。
