Otsuka Yasuo, Kamata Ken
Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.
J Med Ultrason (2001). 2023 Aug 16. doi: 10.1007/s10396-023-01346-3.
Endoscopic ultrasonography (EUS) is superior to other imaging modalities in the detection of pancreatic masses, although differentiating the types of pancreatic masses detected on EUS remains challenging. However, the value of contrast-enhanced harmonic EUS (CH-EUS) using ultrasound contrast agents for this differentiation has been reported. CH-EUS plays a pivotal role in analysis of small lesions that can only be detected with EUS. Recently, CH-EUS was used for staging and/or determining the resectability of pancreatic cancer in several clinical trials. In addition, it is used to estimate the response of pancreatic cancer to chemotherapy and to determine the prognosis in cases of pancreatic cancer and pancreatic neuroendocrine neoplasms. It is also postulated that CH-EUS improves the diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) through complementary diagnoses using CH-EUS and EUS-FNAB, or CH-EUS-guided EUS-FNAB. Thus, CH-EUS has been employed for various qualitative diagnoses, including differentiation of pancreatic masses. Second-generation contrast agents such as Sonazoid are used clinically for ultrasound diagnostic imaging of liver and breast disease. The positioning of CH-EUS with Sonazoid as a test for the diagnosis of solid pancreatic tumors is an issue for further studies.
内镜超声检查（EUS）在检测胰腺肿块方面优于其他成像方式，尽管区分EUS检测到的胰腺肿块类型仍然具有挑战性。然而，已有报道称使用超声造影剂的对比增强谐波EUS（CH-EUS）在这种区分中具有价值。CH-EUS在分析只能通过EUS检测到的小病变中起着关键作用。最近，在几项临床试验中，CH-EUS被用于胰腺癌的分期和/或确定其可切除性。此外，它还用于评估胰腺癌对化疗的反应以及确定胰腺癌和胰腺神经内分泌肿瘤病例的预后。还推测CH-EUS通过CH-EUS和内镜超声引导下细针穿刺活检（EUS-FNAB）的互补诊断或CH-EUS引导的EUS-FNAB提高内镜超声引导下细针穿刺活检（EUS-FNAB）的诊断性能。因此，CH-EUS已被用于各种定性诊断，包括胰腺肿块的鉴别。第二代造影剂如声诺维在临床上用于肝脏和乳腺疾病的超声诊断成像。将使用声诺维的CH-EUS定位为实性胰腺肿瘤诊断的一项检测是有待进一步研究的问题。
