1 Department of Radiology, Sejong General Hospital, Gyeonggi-do, Korea.
2 Department of Radiology, Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, Korea.
AJR Am J Roentgenol. 2018 Mar;210(3):518-525. doi: 10.2214/AJR.17.18449. Epub 2018 Jan 11.
The objective of our study was to evaluate the detection rate of incidental pancreatic cysts on transabdominal ultrasound (TAUS) as well as factors influencing detection rates.
Nine hundred thirty-eight patients with 1064 pancreatic cysts who underwent both TAUS and other imaging examinations including CT, MRI, or endoscopic ultrasound (EUS) were enrolled. We reviewed formal reports and assessed the effect of cyst size and location and the effect of the correlative images for cyst detection on TAUS. Statistical analyses were performed using the chi-square test, t test, and Cramér value (V).
The overall detection rate of TAUS was 88.3% (940/1064). Cysts detected on TAUS were more often in younger patients and male patients. The detected cysts (median, 13 mm; interquartile range [IQR], 8-18 mm) were significantly larger than the undetected cysts (median, 10 mm; IQR, 6-14 mm) (p < 0.0001). However, waist circumference did not affect the detection rate. The detection rate was significantly improved from 49.2% (289/587) to 86.7% (830/957) when TAUS was performed after correlative imaging (p < 0.001). Although the detection rate for cysts in the entire pancreas was significantly increased with correlative images (p < 0.001), the detection rate for cysts in the uncinate process showed a much greater increase using correlative images (p < 0.001). However, detection of cysts in the tail of the pancreas showed the least improvement using correlative images. The detection rate was significantly improved with correlative images for cysts 25 mm or smaller.
Because the detection rate of TAUS for pancreatic cysts was significantly improved after CT, MRI, or EUS, TAUS could be a useful surveillance imaging tool for pancreatic cysts incidentally detected on CT, MRI, or EUS.
本研究旨在评估经腹超声（TAUS）检测偶然发现的胰腺囊肿的检出率，以及影响检出率的因素。
共纳入 938 例患者，共 1064 个胰腺囊肿，这些患者均同时接受了 TAUS 及其他影像学检查（包括 CT、MRI 或内镜超声[EUS]）。我们回顾了正式报告，并评估了囊肿大小和位置以及相关图像对 TAUS 中囊肿检测的影响。采用卡方检验、t 检验和 Cramér 值（V）进行统计学分析。
TAUS 的总体检出率为 88.3%（940/1064）。在 TAUS 上检测到的囊肿更常见于年轻患者和男性患者。检测到的囊肿（中位数，13mm；四分位距[IQR]，8-18mm）明显大于未检测到的囊肿（中位数，10mm；IQR，6-14mm）（p<0.0001）。然而，腰围大小并不影响检出率。当在进行相关影像学检查后行 TAUS 时，检出率从 49.2%（289/587）显著提高至 86.7%（830/957）（p<0.001）。虽然整个胰腺的囊肿检出率随着相关影像学检查而显著提高（p<0.001），但钩突部的囊肿检出率提高幅度更大（p<0.001）。然而，胰腺尾部的囊肿检出率改善幅度最小。对于 25mm 或更小的囊肿，行相关影像学检查后检出率显著提高。
由于 CT、MRI 或 EUS 后 TAUS 检测胰腺囊肿的检出率显著提高，因此 TAUS 可作为 CT、MRI 或 EUS 偶然发现的胰腺囊肿的一种有用的监测影像学工具。
