Digestive Diseases Section, Yale University School of Medicine, New Haven, CT 06520, USA.
Pancreas. 2011 Oct;40(7):1070-2. doi: 10.1097/MPA.0b013e31821f65e3.
A retrospective review conducted to determine the utility of endoscopic ultrasound (EUS) examination of the pancreas after initial pancreatic cyst detection with cross-sectional imaging.
A retrospective review of 145 patients referred for EUS for evaluation of pancreas cystic lesions. Initial cross-sectional imaging reports were reviewed and compared to subsequent EUS findings. Findings evaluated included cyst size, number, multifocality, presence in different surgical fields, cyst wall nodularity, main pancreatic duct (PD) dilation, communication with PD, and features suggestive of serous cystadenoma.
Compared to computed tomographic scan, EUS more frequently identified pancreatic cystic lesion multifocality (47% vs 13%, P < 0.0001) and their presence in different surgical fields (33.3% vs 4.2%, P < 0.0001). Compared to magnetic resonance imaging, EUS was superior in identifying multifocality (58% vs 34%, P = 0.0002) and the presence of cysts in different surgical fields (42% vs. 26%, P = 0.021). Malignancy was suspected or confirmed in 3 patients by EUS fine-needle aspiration cytology, not suspected by cross-sectional imaging. Endoscopic ultrasound identified unappreciated features of serous cystadenomas in 10 patients.
Endoscopic ultrasound identified synchronous pancreatic cystic lesions unappreciated by initial cross-sectional imaging, with undetected cysts frequently outside of typical resection margins. In addition, EUS identified the presence of unappreciated high- or low-risk characteristics in a small percentage of patients.
回顾性分析经横断面影像学检查发现胰腺初始囊肿后行内镜超声（EUS）检查的效用。
对 145 例因胰腺囊性病变而行 EUS 评估的患者进行回顾性分析。回顾分析初始横断面影像学报告，并与后续 EUS 结果进行比较。评估的结果包括囊肿大小、数量、多发性、不同手术部位的存在、囊壁结节、主胰管（PD）扩张、与 PD 的连通性以及提示浆液性囊腺瘤的特征。
与 CT 扫描相比，EUS 更频繁地识别胰腺囊性病变的多发性（47% vs 13%，P < 0.0001）和不同手术部位的存在（33.3% vs 4.2%，P < 0.0001）。与 MRI 相比，EUS 在识别多发性（58% vs 34%，P = 0.0002）和不同手术部位的囊肿存在（42% vs. 26%，P = 0.021）方面更具优势。EUS 细针抽吸细胞学检查怀疑或证实 3 例患者存在恶性肿瘤，而横断面影像学检查未怀疑。EUS 发现 10 例患者存在浆液性囊腺瘤的未被察觉的特征。
EUS 识别出初始横断面影像学检查未发现的胰腺囊性病变，且未被发现的囊肿常位于典型切除范围之外。此外，EUS 还在一小部分患者中识别出未被察觉的高低风险特征。
