Tantau Marcel, Pop Teodora, Badea Radu, Spirchez Zeno, Moşteanu Ofelia, Tantau Alina
3rd Medical Clinic, University of Medicine and Pharmacy, Croitorilor Street no.19-21, Cluj-Napoca, Romania.
J Gastrointestin Liver Dis. 2008 Jun;17(2):217-22.
Diseases of the biliary and pancreatic ducts are often difficult to diagnose. Although transcutaneous ultrasonography, computer tomography and magnetic resonance greatly improved in performance, two major problems have not been completely solved yet: first, the differentiation of malignant and benign bile duct strictures, and, second, the assessment of the resectability of carcinomas underlying biliary strictures. Ultrasound probes can be inserted through the working channel of the duodenoscope and passed selectively both into the biliary and pancreatic ducts. Ultrasound frequencies of 20 or 30 MHz enable a penetration of up to 2 cm and a resolution of 0.07 to 0.18 mm. The main clinical indication for intraductal ultrasonography of the biliary tract is obstructive jaundice, which requires assessment of bile duct strictures and local tumor staging. Miniprobes can contribute to the differential diagnosis of strictures localized in the main pancreatic duct, and also to localizing small endocrine tumors. Small tumors of the papilla of Vater can be staged before a possible endoscopic resection. Feasibility of the method is excellent in expert hands with almost no added morbidity.
胆管和胰管疾病往往难以诊断。尽管经皮超声检查、计算机断层扫描和磁共振成像在性能上有了很大提高，但仍有两个主要问题尚未完全解决：其一，恶性和良性胆管狭窄的鉴别；其二，胆管狭窄基础上的癌肿可切除性的评估。超声探头可通过十二指肠镜的工作通道插入，并选择性地进入胆管和胰管。20或30兆赫的超声频率可实现高达2厘米的穿透深度和0.07至0.18毫米的分辨率。胆管腔内超声检查的主要临床适应症是梗阻性黄疸，这需要评估胆管狭窄和局部肿瘤分期。微型探头有助于主胰管内狭窄的鉴别诊断，也有助于小内分泌肿瘤的定位。在可能进行内镜切除之前，可对 Vater 乳头的小肿瘤进行分期。在专家手中，该方法的可行性极佳，几乎不会增加发病率。
