Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania.
Endosc Ultrasound. 2012 Oct;1(3):150-5. doi: 10.7178/eus.03.006.
Pancreatic neuroendocrine tumors (PNET) represent rare, heterogeneous tumors with clinical, imaging and treatment particularities. The aim of this study was to assess the role of power Doppler endoscopic ultrasound (EUS) in the diagnosis and characterization of PNET.
All consecutive patients with PNET assessed by power Doppler EUS in the Research Centre of Gastroenterology and Hepatology Craiova, Romania, in the past 51 months were included in the study. All EUS examinations were performed initially in gray-scale mode, followed by power Doppler mode examinations, before and after contrast-enhancement. Each recorded EUS movie was further subjected to post-processing using a computer-enhanced dynamic analysis using a special plug-in which permitted assessment of vascularity index (EUS-VI).
Based on the analysis of all consecutive malignant focal pancreatic masses diagnosed in the study period, a total number of 131 consecutive patients were included: 14 patients with pancreatic neuroendocrine tumors and 117 patients with pancreatic adenocarcinoma. The sensitivity of the pre-contrast EUS-VI for the diagnosis of PNET was 71.43%, similar to EUS-FNA. After contrast enhancement, the EUS-VI is also higher in PNET (27.07%) as compared to pancreatic adenocarcinoma where it was significantly lower 9.82% (P < 0.001). However, the sensitivity of EUS-VI after contrast enhancement for the diagnosis of PNET was 100%, higher than pre-contrast EUS-VI, with an acceptable specificity (79.49%) and better accuracy (81.68%).
Power Doppler EUS represents a useful method in the initial assessment of PNET. Using evaluation of vascularity through EUS-VI, the differentiation between PNET and pancreatic cancer could be possible, especially in the subgroup of patients where EUS-guided fine needle aspiration is falsely negative.
胰腺神经内分泌肿瘤（PNET）是一种罕见的、异质性肿瘤，具有独特的临床、影像学和治疗特点。本研究旨在评估能量多普勒内镜超声（EUS）在 PNET 诊断和特征描述中的作用。
本研究纳入了过去 51 个月内在罗马尼亚克勒拉什胃肠病学和肝脏研究中心接受能量多普勒 EUS 评估的所有 PNET 连续患者。所有 EUS 检查均首先以灰阶模式进行，然后以能量多普勒模式进行检查，在增强前后进行。对每部记录的 EUS 电影进行计算机增强动态分析的后处理，使用特殊插件评估血管指数（EUS-VI）。
根据研究期间诊断的所有连续恶性胰腺局灶性肿块的分析，共纳入 131 例连续患者：14 例胰腺神经内分泌肿瘤患者和 117 例胰腺腺癌患者。增强前 EUS-VI 对 PNET 的诊断敏感性为 71.43%，与 EUS-FNA 相似。增强后，EUS-VI 在 PNET 中也更高（27.07%），而在胰腺腺癌中显著降低（9.82%，P<0.001）。然而，增强后 EUS-VI 对 PNET 的诊断敏感性为 100%，高于增强前 EUS-VI，具有可接受的特异性（79.49%）和更好的准确性（81.68%）。
能量多普勒 EUS 是 PNET 初步评估的有用方法。通过 EUS-VI 评估血管生成，可以对 PNET 和胰腺癌进行区分，特别是在 EUS 引导下细针抽吸术结果为假阴性的患者亚组中。
