内镜超声在胰腺分裂症诊断中的作用。
Role of endoscopic ultrasound in the diagnosis of pancreas divisum.
机构信息
Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India.
出版信息
Endosc Ultrasound. 2013 Jan;2(1):7-10. doi: 10.7178/eus.04.003.
OBJECTIVE
The published data on the accuracy of the detection of pancreas divisum by endoscopic ultrasound (EUS) is limited. In this study, we evaluate the accuracy of detection of pancreas divisum by radial EUS in patients with chronic pancreatitis.
METHODS
We retrospectively evaluated patients with chronic pancreatitis who underwent EUS followed by endoscopic retrograde cholangiopancreatography (ERCP) in the last four years to identify patients with complete pancreas divisum.
RESULTS
One hundred and forty six patients with chronic pancreatitis underwent EUS examination and 20 patients (13.6%) had pancreas divisum. The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of absence of stack sign on EUS for the diagnosis of pancreas divisum were 50%, 97%, 73%, 93% and 91%, respectively and for the inability to trace pancreatic duct from the head to the body were 100%, 96%, 80%, 100% and 96%, respectively.
CONCLUSION
EUS can diagnose pancreas divisum in a majority of patients. Pancreas divisum can be reliably excluded if pancreatic duct could be tracked backwards from the head to the body around the genu.
目的
经内镜超声（EUS）检测胰腺分裂的准确性的相关数据有限。本研究旨在评估 EUS 对慢性胰腺炎患者胰腺分裂的检测准确性。
方法
我们回顾性评估了过去四年中接受 EUS 检查并随后进行内镜逆行胰胆管造影（ERCP）的慢性胰腺炎患者，以确定是否存在完全性胰腺分裂。
结果
146 例慢性胰腺炎患者接受了 EUS 检查，20 例（13.6%）患者存在胰腺分裂。EUS 上无“堆栈征”对胰腺分裂的诊断的总体敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 50%、97%、73%、93%和 91%，而无法从胰头追踪胰管到体部的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 100%、96%、80%、100%和 96%。
结论
EUS 可诊断大多数患者的胰腺分裂。如果能够从胰头沿着峡部追踪胰管到体部，即可可靠地排除胰腺分裂。
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