Brugge W R
Gastrointestinal Unit, Massachusetts General Hospital, Boston, USA.
Gastrointest Endosc Clin N Am. 1995 Oct;5(4):741-53.
Endoscopic ultrasound (EUS) is the most sensitive imaging test available for examining the pancreas and associated structures. Small (< 2 cm) pancreatic malignancies can be detected with accuracy rates of more than 90%. Several EUS criteria have been proposed for their ability to diagnose malignant venous invasion. Although obstruction of a mesenteric vein and the resulting venous collaterals is a specific sign of unresectability, it is a rather insensitive parameter. As an alternative, signs of venous wall invasion, such as "irregular wall" have been proposed as being sensitive (67%-100%) and specific (100%) for malignant invasion of mesenteric veins. EUS appears to be particularly sensitive for detecting invasion of the portal and splenic veins. In contrast, the superior mesentera veins are more difficult to image with EUS and the results of staging of pancreatic masses demonstrate poor sensitivity (12%-17%) for detecting vascular invasion of the superior mesenteric vein.
内镜超声（EUS）是用于检查胰腺及相关结构的最敏感的影像学检查。小的（<2cm）胰腺恶性肿瘤检测准确率超过90%。已经提出了几种EUS标准用于诊断恶性静脉侵犯的能力。虽然肠系膜静脉阻塞及由此产生的静脉侧支是不可切除的特异性征象，但它是一个相当不敏感的参数。作为替代，静脉壁侵犯的征象，如“壁不规则”已被提出对肠系膜静脉恶性侵犯敏感（67%-100%）且特异（100%）。EUS似乎对检测门静脉和脾静脉侵犯特别敏感。相比之下，肠系膜上静脉用EUS成像更困难，胰腺肿块分期结果显示对检测肠系膜上静脉血管侵犯的敏感性较差（12%-17%）。
