对比增强谐波内镜超声在胰腺癌门静脉侵犯诊断中的应用价值。
Utility of contrast-enhanced harmonic EUS for diagnosis of portal vein invasion by pancreatic cancer.
作者信息
Nakai Atsushi, Kamata Ken, Hyodo Tomoko, Chikugo Takaaki, Hara Akane, Otsuka Yasuo, Tanaka Hidekazu, Yoshikawa Tomoe, Ishikawa Rei, Okamoto Ayana, Yamazaki Tomohiro, Omoto Shunsuke, Minaga Kosuke, Yamao Kentaro, Takenaka Mamoru, Chiba Yasutaka, Watanabe Tomohiro, Matsumoto Ippei, Takeyama Yoshifumi, Kudo Masatoshi
机构信息
Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
Department of Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
出版信息
Endosc Ultrasound. 2022 Sep-Oct;11(5):401-406. doi: 10.4103/EUS-D-21-00185.
BACKGROUND
The value of contrast-enhanced harmonic EUS (CH-EUS) for diagnosis of portal vein invasion in patients with pancreatic cancer was evaluated.
PATIENTS AND METHODS
This single-center, retrospective study included consecutive patients with pancreatic cancer who underwent both surgical resection after preoperative EUS, CH-EUS, and contrast-enhanced computed tomography (CE-CT) examinations between April 2015 and August 2017. CH-EUS evaluation was performed during the late phase. Portal vein invasion on EUS and CH-EUS was defined as no continuity in the line of the vessel wall. Definition of portal vein invasion on CE-CT was based on the Loyer's criteria. The accuracy of three modalities for diagnosis of invasion into the portal vein was compared using the McNemar's test.
RESULTS
Eighty-eight patients (mean age: 71.0 years, ratio of male to female: 48:40) were eligible. Postoperative pathological results were as follows: seven cases of portal vein invasion; 81 cases without. Diagnostic accuracy of EUS, CH-EUS, and CE-CT for diagnosing invasion into the portal vein was 72.7%, 93.2%, and 81.8%, respectively. The differences between CH-EUS and CE-CT (P = 0.0094) and CH-EUS and EUS (P = 0.0022) were significant. EUS and CE-CT were comparable.
CONCLUSION
CH-EUS is useful for diagnosis of portal vein invasion by pancreatic cancer.
背景
评估对比增强谐波内镜超声（CH-EUS）对胰腺癌患者门静脉侵犯的诊断价值。
患者与方法
这项单中心回顾性研究纳入了2015年4月至2017年8月期间连续接受术前超声内镜（EUS）、CH-EUS及对比增强计算机断层扫描（CE-CT）检查后行手术切除的胰腺癌患者。CH-EUS评估在晚期进行。EUS和CH-EUS上的门静脉侵犯定义为血管壁线的连续性中断。CE-CT上门静脉侵犯的定义基于洛耶标准。采用McNemar检验比较三种检查方式对门静脉侵犯诊断的准确性。
结果
88例患者（平均年龄：71.0岁，男女比例：48:40）符合条件。术后病理结果如下：7例门静脉侵犯；81例无侵犯。EUS、CH-EUS和CE-CT对门静脉侵犯诊断的准确率分别为72.7%、93.2%和81.8%。CH-EUS与CE-CT（P = 0.0094）以及CH-EUS与EUS（P = 0.0022）之间的差异具有统计学意义。EUS和CE-CT相当。
结论
CH-EUS对胰腺癌门静脉侵犯的诊断有帮助。
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