Hentschel Viktoria, Beckmann Jennice, Kratzer Wolfgang, Arnold Frank, Seufferlein Thomas, Walter Benjamin, Kleger Alexander, Müller Martin
Department of Gastroenterology, Clinic of Internal Medicine 1, University Hospital of Ulm, 89081 Ulm, Germany.
Institute for Molecular Oncology and Stem Cell Biology, University Hospital of Ulm, 89081 Ulm, Germany.
J Clin Med. 2022 Oct 19;11(20):6176. doi: 10.3390/jcm11206176.
Pancreatic cystic lesions are a frequent incidental finding in abdominal imaging. Despite its usually benign background, a small fraction exhibiting features suspicious for cancerous development demands continuous follow-up or surgical removal. Current guidelines advocate magnetic resonance imaging and endoscopic ultrasound to evaluate the risk of malignancy, whereas transabdominal ultrasound is perceived as subordinate imaging. The objective of this study was to analyze cyst detection rates of latest-generation ultrasound machines compared to magnetic resonance imaging, computed tomography, and endosonographic ultrasound and to determine inter-rater reliability. The results showed that large cysts facilitate their visualization by transabdominal ultrasound while detection rates are independent of the anatomical part of the pancreas in which they were sited. Changes in the pancreatic duct width, a connection to the pancreatic duct system, and the architectural characteristics of cysts are poorly recognized by transabdominal ultrasound compared to magnetic resonance imaging and endoscopic ultrasound. Computed tomography imaging is preferred over transabdominal ultrasound to detect calcifications and regional lymphadenopathy. Even if conducted by experienced investigators, transabdominal ultrasound examinations fail to agree with magnetic resonance imaging scans regarding cyst detection rates (κ = 0.093).
胰腺囊性病变在腹部影像学检查中经常是偶然发现的。尽管其背景通常为良性，但一小部分表现出可疑癌变特征的病变需要持续随访或手术切除。当前指南提倡使用磁共振成像和内镜超声来评估恶性风险，而经腹超声则被视为次要的成像手段。本研究的目的是分析最新一代超声机器与磁共振成像、计算机断层扫描和内镜超声相比的囊肿检出率，并确定评分者间的可靠性。结果表明，大囊肿通过经腹超声更容易被观察到，而检出率与囊肿所在胰腺的解剖部位无关。与磁共振成像和内镜超声相比，经腹超声对胰管宽度的变化、与胰管系统的连接以及囊肿的结构特征的识别较差。计算机断层扫描成像在检测钙化和区域淋巴结病方面优于经腹超声。即使由经验丰富的研究人员进行，经腹超声检查在囊肿检出率方面也与磁共振成像扫描不一致（κ = 0.093）。
