对比增强谐波内镜超声定量灌注分析对胰腺肿瘤的特征性研究

Characterization of Pancreatic Tumors with Quantitative Perfusion Analysis in Contrast-Enhanced Harmonic Endoscopic Ultrasonography.

作者信息

Omoto Shunsuke, Takenaka Mamoru, Kitano Masayuki, Miyata Takeshi, Kamata Ken, Minaga Kosuke, Arizumi Tadaaki, Yamao Kentaro, Imai Hajime, Sakamoto Hiroki, Harwani Yogesh, Sakurai Toshiharu, Watanabe Tomohiro, Nishida Naoshi, Takeyama Yoshifumi, Chiba Yasutaka, Kudo Masatoshi

机构信息

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.

出版信息

Oncology. 2017;93 Suppl 1:55-60. doi: 10.1159/000481231. Epub 2017 Dec 20.

DOI:10.1159/000481231

PMID:29258065

Abstract

OBJECTIVES

This study evaluated whether quantitative perfusion analysis with contrast-enhanced harmonic (CH) endoscopic ultrasonography (EUS) characterizes pancreatic tumors, and compared the hemodynamic parameters used to diagnose pancreatic carcinoma.

METHODS

CH-EUS data from pancreatic tumors of 76 patients were retrospectively analyzed. Time-intensity curves (TIC) were generated to depict changes in signal intensity over time, and 6 parameters were assessed: baseline intensity, peak intensity, time to peak, intensity gain, intensity at 60 s (I60), and reduction rate. These parameters were compared between pancreatic carcinomas (n = 41), inflammatory pseudotumors (n = 14), pancreatic neuroendocrine tumors (n = 14), and other tumors (n = 7). All 6 TIC parameters and subjective analysis for diagnosing pancreatic carcinoma were compared.

RESULTS

Values of peak intensity and I60 were significantly lower and time to peak was significantly longer in the groups with pancreatic carcinomas than in the other 3 tumor groups (p < 0.05). Reduction rate was significantly higher in pancreatic carcinomas than in pancreatic neuroendocrine tumors (p < 0.05). Areas under the receiver-operating characteristic curves for the diagnosis of pancreatic carcinoma using subjective analysis, baseline intensity, peak intensity, intensity gain, I60, time to peak, and reduction rate, were 0.817, 0.664, 0.810, 0.751, 0.845, 0.777, and 0.725, respectively. I60 was the most accurate parameter for differentiating pancreatic carcinomas from the other groups, giving values of sensitivity/specificity of 92.7/68.6% when optimal cutoffs were chosen.

CONCLUSIONS

In pancreatic carcinomas, TIC patterns were markedly different from the other tumor types, with I60 being the most accurate diagnostic parameter. Quantitative perfusion analysis is useful for differentiating pancreatic carcinomas from other pancreatic tumors.

摘要

目的

本研究评估了使用对比增强谐波（CH）内镜超声（EUS）进行定量灌注分析是否能对胰腺肿瘤进行特征性描述，并比较了用于诊断胰腺癌的血流动力学参数。

方法

回顾性分析了76例胰腺肿瘤患者的CH-EUS数据。生成时间-强度曲线（TIC）以描述信号强度随时间的变化，并评估了6个参数：基线强度、峰值强度、达峰时间、强度增益、60秒时的强度（I60）和下降率。比较了胰腺癌（n = 41）、炎性假瘤（n = 14）、胰腺神经内分泌肿瘤（n = 14）和其他肿瘤（n = 7）之间的这些参数。比较了所有6个TIC参数以及用于诊断胰腺癌的主观分析。

结果

胰腺癌组的峰值强度和I60值显著低于其他3个肿瘤组，达峰时间显著长于其他3个肿瘤组（p < 0.05）。胰腺癌的下降率显著高于胰腺神经内分泌肿瘤（p < 0.05）。使用主观分析、基线强度、峰值强度、强度增益、I60、达峰时间和下降率诊断胰腺癌的受试者工作特征曲线下面积分别为0.817、0.664、0.810、0.751、0.845、0.777和0.725。I60是区分胰腺癌与其他组最准确的参数，选择最佳临界值时，其敏感性/特异性值为92.7/68.6%。