Gleeson F C, Levy M J, Papachristou G I, Pelaez-Luna M, Rajan E, Clain J E, Topazian M D
Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Endoscopy. 2007 Jul;39(7):620-4. doi: 10.1055/s-2007-966337. Epub 2007 Jun 5.
Celiac ganglia can be visualized by endoscopic ultrasound (EUS). It is unknown how often ganglia are visualized during EUS, and what clinical factors are associated with ganglion visualization. The aim of this study was to prospectively evaluate the frequency of visualization of presumed celiac ganglia by EUS and to identify factors that predict their visualization.
Clinical, demographic, EUS, and cytologic data were collected prospectively from 200 unselected patients who were undergoing EUS in a tertiary referral centre. When presumed celiac ganglia were visualized, their size, number, location, and echo features were noted. When presumed ganglia were aspirated, the results of cytology were recorded.
The most common indication for EUS was investigation of a pancreatic mass or cyst (25 %). Presumed celiac ganglia were identified in 81 % of patients overall. Logistic regression analysis determined that female sex and having no prior history of gastrointestinal surgery were independently associated with ganglion visualization. Among patients whose ganglia were visualized, more ganglia were seen per patient with linear echo endoscopes (2, range 0 - 5) than with radial echo endoscopes (1, range 0 - 4) ( P = 0.001). Presumed celiac ganglia were aspirated in 10 patients; and cytologic examination revealed neural ganglia in all of these.
Celiac ganglia can be visualized by EUS in most patients who undergo upper gastrointestinal EUS examinations, and are best seen with linear-array echo endoscopes. Ganglia can usually be differentiated from lymph nodes on the basis of their endosonographic appearance.
腹腔神经节可通过超声内镜（EUS）进行可视化观察。目前尚不清楚在EUS检查中神经节的可视化频率以及哪些临床因素与神经节的可视化相关。本研究的目的是前瞻性评估EUS检查中假定腹腔神经节的可视化频率，并确定预测其可视化的因素。
前瞻性收集了在一家三级转诊中心接受EUS检查的200例未经筛选患者的临床、人口统计学、EUS及细胞学数据。当观察到假定的腹腔神经节时，记录其大小、数量、位置及回声特征。当对假定的神经节进行穿刺抽吸时，记录细胞学检查结果。
EUS检查最常见的适应证是胰腺肿块或囊肿的检查（25%）。总体上，81%的患者观察到假定的腹腔神经节。逻辑回归分析确定，女性及无胃肠道手术史与神经节的可视化独立相关。在神经节被可视化的患者中，使用线阵回声内镜的患者每人观察到的神经节更多（2个，范围0 - 5个），而使用径向回声内镜的患者每人观察到的神经节较少（1个，范围0 - 4个）（P = 0.001）。10例患者对假定的腹腔神经节进行了穿刺抽吸；细胞学检查显示所有这些神经节均为神经节。
在大多数接受上消化道EUS检查的患者中，腹腔神经节可通过EUS进行可视化观察，使用线阵回声内镜观察效果最佳。通常可根据神经节的内镜超声表现将其与淋巴结区分开来。
