Yamashita Yasunobu, Ashida Reiko, Tamura Takaaki, Shimokawa Toshio, Yamazaki Hirofumi, Kawaji Yuki, Tamura Takashi, Hatamaru Keiichi, Itonaga Masahiro, Kitano Masayuki
Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan.
Department of Human Pathology, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-0012, Japan.
Diagnostics (Basel). 2023 Jun 21;13(13):2132. doi: 10.3390/diagnostics13132132.
Detective flow imaging endoscopic ultrasonography (DFI-EUS) is an innovative imaging modality that was developed to detect fine vessels and low-velocity blood flow without contrast agents. We evaluate its utility for the differential diagnosis of gallbladder lesions and intraductal papillary mucinous neoplasms (IPMNs). We enrolled patients who underwent DFI-EUS, e-FLOW EUS, and contrast-enhanced EUS for gallbladder lesions or IPMNs. The detection of vessels using DFI-EUS and e-FLOW EUS was compared with that via contrast-enhanced EUS and pathological findings. The vessel pattern was also categorized as regular or irregular. Of the 33 lesions included, there were final diagnoses of 13 IPMNs and 20 gallbladder lesions. DFI-EUS was significantly superior to e-FLOW EUS for discriminating between mural nodules and mucous clots and between solid gallbladder lesions and sludge using the presence or absence of vessel detection in lesions ( = 0.005). An irregular vessel pattern with DFI-EUS was a significant predictor of malignant gallbladder lesions ( = 0.002). DFI-EUS is more sensitive than e-FLOW-EUS for vessel detection and the differential diagnosis of gallbladder lesions and IPMNs. Vessel evaluation using DFI-EUS may be a useful and simple method for differentiating between mural nodules and mucous clots in IPMN, between solid gallbladder lesions and sludge, and between malignant and benign gallbladder lesions.
侦探流成像内镜超声检查（DFI-EUS）是一种创新的成像方式，其开发目的是在不使用造影剂的情况下检测细小血管和低速血流。我们评估其在胆囊病变和导管内乳头状黏液性肿瘤（IPMN）鉴别诊断中的效用。我们纳入了接受DFI-EUS、e-FLOW EUS和对比增强EUS检查的胆囊病变或IPMN患者。将DFI-EUS和e-FLOW EUS检测血管的情况与对比增强EUS及病理结果进行比较。血管形态也分为规则或不规则。在纳入的33个病变中，最终诊断为13个IPMN和20个胆囊病变。在通过病变中血管检测的有无来鉴别壁结节与黏液凝块以及实性胆囊病变与胆泥方面，DFI-EUS显著优于e-FLOW EUS（P = 0.005）。DFI-EUS显示的不规则血管形态是恶性胆囊病变的显著预测指标（P = 0.002）。DFI-EUS在血管检测以及胆囊病变和IPMN的鉴别诊断方面比e-FLOW-EUS更敏感。使用DFI-EUS进行血管评估可能是一种有用且简单的方法，可用于鉴别IPMN中的壁结节与黏液凝块、实性胆囊病变与胆泥以及恶性与良性胆囊病变。
