Psar Robert, Urban Ondrej, Cerna Marie, Rohan Tomas, Hill Martin
Faculty of Medicine and Dentistry, Palacký University Olomouc, 775 15 Olomouc, Czech Republic.
Department of Radiology, Vitkovice Hospital, 703 00 Ostrava-Vitkovice, Czech Republic.
Diagnostics (Basel). 2021 Apr 26;11(5):776. doi: 10.3390/diagnostics11050776.
(1) Background. The aim was to define typical features of isoattenuating pancreatic carcinomas on computed tomography (CT) and endosonography and determine the yield of fine-needle aspiration endosonography (EUS-FNA) in their diagnosis. (2) Methods. One hundred and seventy-three patients with pancreatic carcinomas underwent multiphase contrast-enhanced CT followed by EUS-FNA at the time of diagnosis. Secondary signs on CT, size and location on EUS, and the yield of EUS-FNA in isoattenuating and hypoattenuating pancreatic cancer, were evaluated. (3) Results. Isoattenuating pancreatic carcinomas occurred in 12.1% of patients. Secondary signs of isoattenuating pancreatic carcinomas on CT were present in 95.2% cases and included dilatation of the pancreatic duct and/or the common bile duct (85.7%), interruption of the pancreatic duct (76.2%), abnormal pancreatic contour (33.3%), and atrophy of the distal parenchyma (9.5%) Compared to hypoattenuating pancreatic carcinomas, isoattenuating carcinomas were more often localized in the pancreatic head (100% vs. 59.2%; < 0.001). In ROC (receiver operating characteristic) analysis, the optimal cut-off value for the size of isoattenuating carcinomas on EUS was ≤ 25 mm (AUC = 0.898). The sensitivity of EUS-FNA in confirmation of isoattenuating and hypoattenuating pancreatic cancer were 90.5% and 92.8% ( = 0.886). (4) Conclusions. Isoattenuating pancreatic head carcinoma can be revealed by indirect signs on CT and confirmed with high sensitivity by EUS-FNA.
(1) 背景。目的是确定等密度胰腺癌在计算机断层扫描（CT）和内镜超声检查中的典型特征，并确定细针穿刺内镜超声检查（EUS-FNA）在其诊断中的成功率。(2) 方法。173例胰腺癌患者在诊断时接受了多期增强CT检查，随后进行了EUS-FNA。评估了CT上的间接征象、EUS上的大小和位置，以及EUS-FNA对等密度和低密度胰腺癌的诊断成功率。(3) 结果。等密度胰腺癌发生在12.1%的患者中。CT上95.2%的等密度胰腺癌有间接征象，包括胰管和/或胆总管扩张（85.7%）、胰管中断（76.2%）、胰腺轮廓异常（33.3%）和远端实质萎缩（9.5%）。与低密度胰腺癌相比，等密度癌更常位于胰头（100%对59.2%；<0.001）。在ROC（受试者工作特征）分析中，EUS上等密度癌大小的最佳截断值为≤25mm（AUC = 0.898）。EUS-FNA对等密度和低密度胰腺癌诊断的敏感性分别为90.5%和92.8%（P = 0.886）。(4) 结论。等密度胰头癌可通过CT上的间接征象显示，并通过EUS-FNA以高敏感性确诊。
