Dong Yi, Jürgensen Christian, Puri Rajesh, D'Onofrio Mirko, Hocke Michael, Wang Wen-Ping, Atkinson Nathan, Sharma Malay, Dietrich Christoph F
Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032 Shanghai, China.
Department of Hepatology and Gastroenterology, Charite University, 10117 Berlin, Germany.
Endosc Ultrasound. 2018 Mar-Apr;7(2):119-127. doi: 10.4103/2303-9027.210901.
Isolated pancreatic tuberculosis (PTB) is extremely rare worldwide. The purpose of this multicenter retrospective study is to analyze imaging features of histologically confirmed isolated PTB in order to determine the diagnostic features of the new methods contrast enhanced ultrasound (CEUS), ultrasound elastography and contrast enhanced endoscopic ultrasound (CE-EUS).
: We report on a retrospective data collection of 12 cases of PTB confirmed by histology or cytology. All examinations were interpreted by two independent readers in consensus. CEUS, CE-EUS and ultrasound elastography were performed according to the European Federation of Societies for Ultrasound in Medicine and Biology guidelines.
: In PTB patients the common bile duct was never dilated. Multiple retroperitoneal lymph nodes are the second important B-mode ultrasound feature detected in 75% of PTB patients. CE-EUS was performed in three PTB patients demonstrating hyperenhancement. On elastography, all PTB lesions were markedly stiffer than surrounding pancreatic parenchyma.
: Here we report the first time on CEUS and elastography features of PTB. PTB had some typical imaging features with iso- or hyperenhancement on CE(E) US. PTB is markedly stiffer on elastography. If clinicians are aware of clinical features of PTB and conduct appropriate investigations with multiple modalities including B-mode ultrasound, CEUS, and EUS guided fine needle aspiration, diagnosis of PTB without laparotomy is possible and the disease can be effectively treated with anti-tuberculous drugs.
孤立性胰腺结核（PTB）在全球极为罕见。这项多中心回顾性研究的目的是分析经组织学确诊的孤立性PTB的影像学特征，以确定新型方法对比增强超声（CEUS）、超声弹性成像和对比增强内镜超声（CE-EUS）的诊断特征。
我们报告了12例经组织学或细胞学确诊的PTB患者的回顾性数据收集情况。所有检查均由两名独立阅片者达成共识后解读。CEUS、CE-EUS和超声弹性成像均按照欧洲医学与生物学超声学会联合会的指南进行。
在PTB患者中，胆总管从未扩张。多个腹膜后淋巴结是在75%的PTB患者中检测到的第二重要的B超特征。对3例PTB患者进行了CE-EUS检查，显示为高增强。在弹性成像中，所有PTB病变均比周围胰腺实质明显更硬。
我们首次报告了PTB的CEUS和弹性成像特征。PTB在CE（E）US上具有一些典型的影像学特征，表现为等增强或高增强。PTB在弹性成像上明显更硬。如果临床医生了解PTB的临床特征，并通过包括B超、CEUS和EUS引导下细针穿刺在内的多种方式进行适当检查，则无需开腹即可诊断PTB，并且该疾病可以用抗结核药物有效治疗。
