London J F, Shawker T H, Doppman J L, Frucht H H, Vinayek R, Stark H A, Miller L S, Miller D L, Norton J A, Jensen R T
Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892.
Radiology. 1991 Mar;178(3):763-7. doi: 10.1148/radiology.178.3.1994415.
The ability of abdominal ultrasound (US) to help localize gastrinomas was prospectively studied in 79 patients with Zollinger-Ellison syndrome. The results were assessed by means of laparotomy, autopsy, or percutaneous liver biopsy. For hepatic gastrinoma, US had a sensitivity of 63% and a specificity of 100%, with a positive predictive value of 100% and a negative predictive value of 89%. US was slightly less sensitive for detecting gastrinoma in the liver than were computed tomography (CT) (66%) and selective angiography (78%). For detection of extrahepatic gastrinoma, US had a sensitivity of 30%, a specificity of 94%, a positive predictive value of 100%, and a negative predictive value of 25%. US enabled detection of tumor in eight cases not detected with CT and in four not detected with angiography. Specificity for extrahepatic gastrinoma was similar for all three modalities (89%-95%). CT and US were equally effective for the detection of extrahepatic gastrinoma, and angiography was significantly more effective than both US and CT (P less than .01). The authors conclude that US, although of low sensitivity, remains useful as the initial imaging modality in patients with Zollinger-Ellison syndrome.
对79例佐林格-埃利森综合征患者进行前瞻性研究，以探讨腹部超声（US）对胃泌素瘤的定位能力。通过剖腹手术、尸检或经皮肝活检评估结果。对于肝胃泌素瘤，超声的敏感性为63%，特异性为100%，阳性预测值为100%，阴性预测值为89%。与计算机断层扫描（CT）（66%）和选择性血管造影（78%）相比，超声检测肝内胃泌素瘤的敏感性略低。对于肝外胃泌素瘤的检测，超声的敏感性为30%，特异性为94%，阳性预测值为100%，阴性预测值为25%。超声能够检测出8例CT未检测到的肿瘤以及4例血管造影未检测到的肿瘤。三种检查方式对肝外胃泌素瘤的特异性相似（89%-95%）。CT和超声在检测肝外胃泌素瘤方面同样有效，而血管造影比超声和CT都显著更有效（P小于0.01）。作者得出结论，超声尽管敏感性较低，但作为佐林格-埃利森综合征患者的初始成像方式仍有用。
