Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan.
Department of Gastroenterology, Aichi Cancer Center, Nagoya, Japan.
J Hepatobiliary Pancreat Sci. 2022 Aug;29(8):950-959. doi: 10.1002/jhbp.1144. Epub 2022 Apr 20.
BACKGROUND/PURPOSE: The detection ability and role of different imaging modalities to detect pancreatic neuroendocrine neoplasms (PNENs) including small lesions is unclear. This study aimed to compare the ability of endoscopic ultrasound (EUS) and computed tomography (CT) to detect PNENs.
Data of patients who underwent EUS and contrast-enhanced CT and were diagnosed with PNENs were analyzed. The detection rates of pancreatic lesions with EUS and CT based on tumor size and influencing factors were investigated.
For 256 PNEN lesions, the detection rate of EUS was better than that of CT (94.5% vs 86.3%; P < .001). EUS was significantly superior to CT for PNENs ≤5 mm (58.3% vs 16.7%; P = .006) and 5-10 mm (97.7% vs 79.5%; P = .008). There was no significant difference in the detection rate between EUS and CT for PNENs >10 mm (98.4% vs 96.4%; P = .375). Size (≤5 mm) and insulinoma were independent factors associated with poor EUS and CT detection rates.
Endoscopic ultrasound exhibited better detection ability than CT, with an excellent detection rate for PNENs >5 mm, except for insulinomas. CT could detect PNENs >10 mm, which are amenable to treatment.
背景/目的:不同影像学检查方式对包括小病灶在内的胰腺神经内分泌肿瘤(PNEN)的检出能力和作用尚不清楚。本研究旨在比较内镜超声(EUS)和计算机断层扫描(CT)对 PNEN 的检出能力。
分析了接受 EUS 和增强 CT 检查且诊断为 PNEN 的患者的数据。根据肿瘤大小和影响因素,研究了 EUS 和 CT 对胰腺病变的检出率。
对于 256 个 PNEN 病灶,EUS 的检出率优于 CT(94.5%比 86.3%;P<.001)。EUS 对≤5 mm 的 PNEN 明显优于 CT(58.3%比 16.7%;P=0.006)和 5-10 mm 的 PNEN(97.7%比 79.5%;P=0.008)。对于>10 mm 的 PNEN,EUS 和 CT 的检出率无显著差异(98.4%比 96.4%;P=0.375)。大小(≤5 mm)和胰岛素瘤是与 EUS 和 CT 检出率较差相关的独立因素。
EUS 较 CT 具有更好的检出能力,对>5 mm 的 PNEN 检出率较高,但胰岛素瘤除外。CT 可检测到>10 mm 的 PNEN,这些病灶适合治疗。