Zimmer T, Ziegler K, Liehr R M, Stölzel U, Riecken E O, Wiedenmann B
Department of Internal Medicine, Steglitz Medical Center, Free University of Berlin, Germany.
Ann N Y Acad Sci. 1994 Sep 15;733:425-36. doi: 10.1111/j.1749-6632.1994.tb17292.x.
Neuroendocrine tumors (NETs) of the foregut type are frequently smaller than 2 cm in diameter and mainly located in the pancreas or the gastric and duodenal wall. Conventional cross-sectional imaging techniques, such as transabdominal ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) are limited by their inability to detect small tumors and especially those located within the gastrointestinal wall. Endoscopic ultrasonography (EUS) allows detailed visualization of the whole pancreas and almost all parts of the gastric and duodenal walls. Therefore, EUS is an important diagnostic tool for the preoperative localization of NETs of the foregut type. Several studies performed in a retrospective manner, as well as two studies performed in a prospective manner, indicate a clear superiority of EUS as compared to CT, US, MRI, and also angiography in detecting NETs of the foregut type. Somatostatin-receptor scintigraphy (SRS) also detects NETs of the foregut type in a very high percentage of cases, and the combination of EUS and SRS appears to increase the sensitivity even more. Thus EUS and also SRS should be employed early if NETs of the foregut type are suspected. Conventional imaging procedures such as US, CT, and MRI should be mainly used to exclude local and distant metastases.
前肠型神经内分泌肿瘤（NETs）的直径通常小于2厘米，主要位于胰腺或胃和十二指肠壁。传统的横断面成像技术，如经腹超声检查（US）、计算机断层扫描（CT）和磁共振成像（MRI），由于无法检测到小肿瘤，尤其是位于胃肠道壁内的肿瘤，而受到限制。内镜超声检查（EUS）可以详细显示整个胰腺以及胃和十二指肠壁的几乎所有部位。因此，EUS是前肠型NETs术前定位的重要诊断工具。几项回顾性研究以及两项前瞻性研究表明，与CT、US、MRI以及血管造影相比，EUS在检测前肠型NETs方面具有明显优势。生长抑素受体闪烁显像（SRS）在很高比例的病例中也能检测到前肠型NETs，EUS和SRS联合使用似乎能进一步提高敏感性。因此，如果怀疑是前肠型NETs，应尽早采用EUS和SRS。传统的成像检查，如US、CT和MRI，应主要用于排除局部和远处转移。
