Dietrich Christoph F, Jenssen Christian
Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany.
Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ultrasonography. 2020 Apr;39(2):105-113. doi: 10.14366/usg.19039. Epub 2019 Aug 27.
In patients with solid pancreatic lesions (SPLs), the differential diagnosis must be evaluated to determine whether radical surgery, pancreatic parenchyma-saving strategies, or follow-up is indicated. Contrast-enhanced (endoscopic) ultrasonography and elastography facilitate the further characterization of SPLs. The majority of cases of pancreatic ductal adenocarcinoma exhibit hypoenhancement with contrast-enhanced ultrasonography. Elastographically soft SPLs are benign with very few exceptions, whereas stiffer SPLs can be malignant or benign. This article reviews the current use of modern ultrasound imaging techniques, including contrast-enhanced ultrasonography and elastography, for the detection and characterization of SPLs. In particular, the unexcelled diagnostic potential of multiparametric endoscopic ultrasonography to detect and characterize small SPLs is highlighted.
对于实性胰腺病变（SPL）患者，必须评估鉴别诊断结果，以确定是否需要进行根治性手术、保留胰腺实质的策略或随访观察。对比增强（内镜）超声检查和弹性成像有助于进一步明确SPL的特征。大多数胰腺导管腺癌病例在对比增强超声检查中表现为低增强。弹性成像显示柔软的SPL大多为良性，仅有极少数例外，而较硬的SPL可能是恶性或良性。本文综述了现代超声成像技术，包括对比增强超声检查和弹性成像，在SPL检测和特征描述方面的当前应用。特别强调了多参数内镜超声检查在检测和特征描述小SPL方面无与伦比的诊断潜力。
