Nakao Miho, Katayama Kazuhiro, Fukuda Junko, Okagaki Suetsumi, Misu Kozo, Miyazaki Sayako, Matsuno Noritoshi, Ashida Reiko, Ioka Tatsuya, Ito Yuri, Ohkawa Kazuyoshi
Department of Cancer Survey and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan(1).
Department of Cancer Survey and Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan(1); Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan(1).
Eur J Radiol. 2017 Jun;91:10-14. doi: 10.1016/j.ejrad.2017.03.010. Epub 2017 Mar 22.
The ability to detect pancreatic cysts was compared between special ultrasonography (US) examination focusing on the pancreas (special pancreatic US) and routine upper abdominal ultrasonography to objectively assess the ability of the former to detect cysts.
Of 3704 patients who underwent special pancreatic US at our hospital, 186 underwent routine upper abdominal US within six months, had pancreatic cysts, and underwent magnetic resonance imaging (MRI). In these patients, 447 cysts measuring ≥5mm were detected via MRI, which was used as the gold standard. The ability and sensitivity of the US modalities to detect each cyst was determined.
The sensitivity of special pancreatic US was 92.2% (95% confidence interval [CI], 89.7%-94.7%) and that of routine upper abdominal US was 70.2% (95% CI, 66.0%-74.5%). McNemar test (Stata Version 13.1) revealed a significant difference in the cyst (≥5mm) detection sensitivity between the two modalities (p<0.001). An analysis stratified by patients similarly revealed a significant difference between the two modalities (p<0.001). The cyst detection sensitivity was also analyzed in various parts of the pancreas. The sensitivity of special pancreatic US was 88.7% for the uncinate process and inferior head, 97.5% for the head, 97.1% for the body, 89.0% for the body-tail, and 66.7% for the tail, whereas that of routine upper abdominal US was 74.2% for the uncinate process, 69.5% for the head, 81.0% for the body, 67.0% for the body-tail, and 26.7% for the tail. The McNemar test revealed significant differences in the sensitivity of the two modalities for all pancreatic parts (p<0.001-0.016).
Compared with routine upper abdominal US, special pancreatic US had higher sensitivity in detecting pancreatic cysts.
比较专注于胰腺的特殊超声检查（特殊胰腺超声）与常规上腹部超声检查检测胰腺囊肿的能力，以客观评估前者检测囊肿的能力。
在我院接受特殊胰腺超声检查的3704例患者中，186例在6个月内接受了常规上腹部超声检查，患有胰腺囊肿，并接受了磁共振成像（MRI）检查。在这些患者中，通过MRI检测到447个直径≥5mm的囊肿，MRI被用作金标准。确定了两种超声检查方式检测每个囊肿的能力和敏感性。
特殊胰腺超声的敏感性为92.2%（95%置信区间[CI]，89.7%-94.7%），常规上腹部超声的敏感性为70.2%（95%CI，66.0%-74.5%）。McNemar检验（Stata 13.1版本）显示，两种检查方式在囊肿（≥5mm）检测敏感性方面存在显著差异（p<0.001）。按患者分层分析同样显示两种检查方式之间存在显著差异（p<0.001）。还对胰腺各部位的囊肿检测敏感性进行了分析。特殊胰腺超声对钩突和胰头下部的敏感性为88.7%，对胰头为97.5%，对胰体为97.1%，对胰体尾为89.0%，对胰尾为66.7%，而常规上腹部超声对钩突的敏感性为74.2%，对胰头为69.5%，对胰体为81.0%，对胰体尾为67.0%，对胰尾为26.7%。McNemar检验显示，两种检查方式对胰腺所有部位的敏感性均存在显著差异（p<0.001-0.016）。
与常规上腹部超声相比，特殊胰腺超声在检测胰腺囊肿方面具有更高的敏感性。
