Okamoto Yuko, Kawamoto Hirofumi, Takaki Akinobu, Ishida Etsuji, Ogawa Tsuneyoshi, Kuwaki Kenji, Kobayashi Yoshiyuki, Sakaguchi Kohsaku, Shiratori Yasushi
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama 700-8558, Japan.
Eur J Radiol. 2007 Jan;61(1):163-9. doi: 10.1016/j.ejrad.2006.08.014. Epub 2006 Oct 16.
The aim of this study is to evaluate the efficacy of contrast-enhanced ultrasonography for the diagnosis of pancreatic tumors.
Contrast-enhanced ultrasonography with Levovist was performed on 62 consecutive patients (53 with pancreatic cancer, 4 with islet cell tumor, 3 with inflammatory pancreatic tumor, and 2 with metastatic tumor). The vascular and perfusion image phases of the tumors were evaluated and compared with the findings of contrast-enhanced computed tomography.
Contrast-enhanced ultrasonography showed tumor vessels around and/or in the tumor at the vascular image phase in 79% of pancreatic cancer patients (42/53). At the perfusion image phase, 96% of pancreatic cancers (51/53) were classified as hypo-enhancement type. However, tiny spotty or irregular heterogeneous enhanced lesions were found in 84% of hypo-enhanced pancreatic cancer patients (43/51). The presence of small vessels at the vascular image phase was closely correlated with the presence of these intratumor regional enhanced lesions at the perfusion image phase (kappa coefficient=0.42). The sensitivity of contrast-enhanced ultrasonography (100%) for pancreatic cancer was superior to that of contrast-enhanced computed tomography (91%), but no significant difference was observed between the two (McNemar test: p=0.063).
Contrast-enhanced ultrasonography with Levovist successfully visualizes fine vessels and enhancement in pancreatic tumors, and is useful for evaluating pancreatic tumors.
本研究旨在评估超声造影在胰腺肿瘤诊断中的效能。
对62例连续患者（53例胰腺癌、4例胰岛细胞瘤、3例胰腺炎性肿瘤、2例转移瘤）进行了用声诺维的超声造影检查。评估肿瘤的血管和灌注图像期，并与增强CT的结果进行比较。
在血管图像期，79%（42/53）的胰腺癌患者超声造影显示肿瘤周围和/或肿瘤内有肿瘤血管。在灌注图像期，96%（51/53）的胰腺癌被分类为低增强型。然而，在84%（43/51）的低增强型胰腺癌患者中发现了微小斑点状或不规则的不均匀增强病灶。血管图像期小血管的存在与灌注图像期这些肿瘤内局部增强病灶的存在密切相关（kappa系数=0.42）。超声造影对胰腺癌的敏感性（100%）高于增强CT（91%），但两者之间无显著差异（McNemar检验：p=0.063）。
用声诺维的超声造影能成功显示胰腺肿瘤内的细小血管和增强情况，对胰腺肿瘤的评估有帮助。
