Barts and the London NHS Trust, St. Bartholomew's Hospital, West Smithfield, London, UK.
Cancer Imaging. 2004 Mar 29;4(2):84-91. doi: 10.1102/1470-7330.2004.0008.
The role of endoscopic ultrasound (EUS) in the detection of pancreatic islet cell tumours is reviewed. Functioning islet cell tumours are frequently small at presentation (90%< 2 cm). Advances in cross-sectional imaging with CT and MRI have resulted in improved detection rates of these small lesions. The sensitivity of EUS in the detection of insulinoma is similar to helical or multislice CT, i.e. between 82 and 94%, while a combination of both techniques is reported to identify 100% of tumours. EUS may be considered a primary diagnostic tool in these patients. EUS has a secondary role in the detection of gastrinomas as over 50% are malignant and 5% extra-pancreatic in position. CT should be used as a first-line investigation. EUS is valuable in problem solving in these patients. EUS has a role in staging large tumours prior to surgery. EUS-guided fine needle aspiration may provide cytological confirmation of the nature of a tumour prior to surgery.
本文回顾了内镜超声（EUS）在胰岛细胞瘤检测中的作用。功能性胰岛细胞瘤在发病时通常较小（<90%的肿瘤直径<2cm）。CT 和 MRI 等影像学技术的进步提高了这些小病变的检出率。EUS 在胰岛素瘤检测中的灵敏度与螺旋 CT 或多层 CT 相似，约为 82%~94%，而联合应用两种技术据称可以检出 100%的肿瘤。在这些患者中，EUS 可作为主要诊断工具。EUS 在胃泌素瘤检测中具有次要作用，因为超过 50%的胃泌素瘤为恶性，5%的胃泌素瘤位于胰腺外位置。应首先使用 CT 进行检查。EUS 在这些患者的疑难病例中具有重要价值。EUS 可用于术前评估大型肿瘤的分期。EUS 引导下细针抽吸可在术前提供肿瘤性质的细胞学确认。
