Sumi Hajime, Itoh Akihiro, Kawashima Hiroki, Ohno Eizaburo, Itoh Yuya, Nakamura Yosuke, Hiramatsu Takeshi, Sugimoto Hiroyuki, Hayashi Daijuro, Kuwahara Takamichi, Morishima Tomomasa, Kawai Manabu, Furukawa Kazuhiro, Funasaka Kohei, Nakamura Masanao, Miyahara Ryoji, Katano Yoshiaki, Ishigami Masatoshi, Ohmiya Naoki, Goto Hidemi, Hirooka Yoshiki
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Eur J Radiol. 2014 Aug;83(8):1324-31. doi: 10.1016/j.ejrad.2014.05.009. Epub 2014 May 19.
Transabdominal ultrasonography (US) is commonly used for the initial screening of bilio-pancreatic diseases in Asian countries due to its widespread availability, the non-invasiveness and the cost-effectiveness. However, it is considered that US has limits to observe the area, namely the blind area. The observation of the pancreatic tail is particularly difficult. The goal of this study was to examine the pancreatic tail region that cannot be visualized on transverse scanning of the upper abdomen using US with spatial positional information and factors related to visualization, and observation of the tail from the splenic hilum.
Thirty-nine patients with pancreatic/biliary tract disease underwent CT and US with GPS-like technology and fusion imaging for measurement of the real pancreatic length and the predicted/real unobservable (PU and RU) length of the pancreatic tail. RU from US on transverse scanning and the real pancreatic length were used to determine the unobservable area (UA: RU/the real pancreatic length). Relationships of RU with physical and hematological variables that might influence visualization of the pancreatic tail were investigated.
The real pancreatic length was 160.9 ± 16.4mm, RU was 41.0 ± 17.8mm, and UA was 25.3 ± 10.4%. RU was correlated with BMI (R=0.446, P=0.004) and waist circumferences (R=0.354, P=0.027), and strongly correlated with PU (R=0.788, P<0.001). The pancreatic tail was visible from the splenic hilum in 22 (56%) subjects and was completely identified in 13 (33%) subjects.
Combined GPS-like technology with fusion imaging was useful for the objective estimation of the pancreatic blind area.
在亚洲国家，经腹超声检查（US）因其广泛普及、无创性和成本效益，常用于胆胰疾病的初步筛查。然而，人们认为超声在观察区域方面存在局限性，即存在盲区。胰腺尾部的观察尤其困难。本研究的目的是利用带有空间位置信息的超声检查以及与可视化相关的因素，检查在上腹部横向扫描时无法可视化的胰腺尾部区域，并从脾门观察胰腺尾部。
39例胰腺/胆道疾病患者接受了CT检查以及采用类似GPS技术和融合成像的超声检查，以测量胰腺实际长度以及胰腺尾部预测/实际不可观察（PU和RU）长度。横向扫描超声检查的RU和胰腺实际长度用于确定不可观察区域（UA：RU/胰腺实际长度）。研究了RU与可能影响胰腺尾部可视化的身体和血液学变量之间的关系。
胰腺实际长度为160.9±16.4mm，RU为41.0±17.8mm，UA为25.3±10.4%。RU与体重指数（R=0.446，P=0.004）和腰围（R=0.354，P=0.027）相关，与PU高度相关（R=0.788，P<0.001）。22例（56%）受试者的胰腺尾部可从脾门看到，13例（33%）受试者的胰腺尾部被完全识别。
类似GPS技术与融合成像相结合有助于客观估计胰腺盲区。
