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内镜超声(EUS)弹性成像和应变率,能否有助于鉴别胰腺良恶性病变?

Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in differentiating malignant from benign pancreatic lesions?

作者信息

Okasha Hussein Hassan, Mahdy Reem Ezzat, Elkholy Shaimaa, Hassan Mohamed Sayed, El-Mazny Ahmed Nabil, Hadad Kareem Essam Eldin, Saeed Moustafa, El-Nady Mohamed, Elbalky Osama Soliman, Ashraf Asem, El-Magd Amr Abo, Awad Abeer

机构信息

Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut General Surgery Department, Damanhur Teaching Hospital, Al Buhayrah Internal Medicine Department, Armed forces college of medicine, Cairo Gastroenterology Department, Military Medical Academy, Egypt.

出版信息

Medicine (Baltimore). 2018 Sep;97(36):e11689. doi: 10.1097/MD.0000000000011689.

DOI:10.1097/MD.0000000000011689
PMID:30200064
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6133468/
Abstract

Evaluating the role of endoscopic ultrasound (EUS) elastography and strain ratio in differentiation between malignant and benign pancreatic lesions.Three hundred twenty-five patients with solid pancreatic lesions were enrolled in this prospective study from 2014 to 2017. EUS real-time elastography scoring and strain ratio were done to all patients and compared to the final diagnosis to assess its sensitivity, specificity, positive and negative predictive values (PPV and NPV) in differentiating malignant from benign lesions.A cut-off value of 4.2 we had sensitivity of 95%, specificity of 63%, PPV of 89%, NPV of 81%, and accuracy of 87%. Another cut-off value of 10.9 showed a sensitivity of 75%, specificity of 88%, PPV of 95%, NPV of 54%, and accuracy of 79%. Adding the elastography to the better cut-off value gave a sensitivity of 97%, specificity of 63%, PPV of 89%, NPV of 88%, and accuracy of 89%.Real-time elastography and strain ration are valuable in differentiating malignant from pancreatic lesions.

摘要

评估内镜超声(EUS)弹性成像及应变率在鉴别胰腺良恶性病变中的作用。2014年至2017年,325例胰腺实性病变患者纳入了这项前瞻性研究。对所有患者进行EUS实时弹性成像评分及应变率测定,并与最终诊断结果进行比较,以评估其在鉴别胰腺良恶性病变中的敏感性、特异性、阳性预测值和阴性预测值(PPV和NPV)。当截断值为4.2时,敏感性为95%,特异性为63%,PPV为89%,NPV为81%,准确性为87%。另一个截断值为10.9时,敏感性为75%,特异性为88%,PPV为95%,NPV为54%,准确性为79%。采用更好的截断值并结合弹性成像,敏感性为97%,特异性为63%,PPV为89%,NPV为88%,准确性为89%。实时弹性成像及应变率在鉴别胰腺良恶性病变中具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/8e7cc0733ca1/medi-97-e11689-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/a0da74a517d0/medi-97-e11689-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/7f634248489e/medi-97-e11689-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/462390ea18dd/medi-97-e11689-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/8e7cc0733ca1/medi-97-e11689-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/a0da74a517d0/medi-97-e11689-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/7f634248489e/medi-97-e11689-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/462390ea18dd/medi-97-e11689-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3183/6133468/8e7cc0733ca1/medi-97-e11689-g004.jpg

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United European Gastroenterol J. 2017 Mar;5(2):236-246. doi: 10.1177/2050640616640635. Epub 2016 Jun 23.
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