Furukawa T, Oohashi K, Yamao K, Naitoh Y, Hirooka Y, Taki T, Itoh A, Hayakawa S, Watanabe Y, Goto H, Hayakawa T
Aichi Cancer Center Hospital, Nagoya, Japan.
Endoscopy. 1997 Aug;29(6):561-9. doi: 10.1055/s-2007-1004259.
Intraductal ultrasound (IDUS) probes mounted with 30 MHz or 20 MHz transducers were evaluated in the diagnosis of 239 patients with pancreatic disease (including 48 cancers, 90 mucin-producing tumors, seven islet-cell tumors, two metastatic pancreatic tumors, seven serous cystadenomas, one pancreatic teratoma, three solid cystic tumors, 49 cases of chronic pancreatitis, 25 cases of focal pancreatitis, and seven cases of pancreatolithiasis). The probe was inserted via the papilla into the main pancreatic duct. In terms of resolution, IDUS at 20 MHz was able to image cystic lesions of less than 30 mm in diameter and solid lesions of less than 20 mm in diameter. With regard to vessels, IDUS was able to image the entire cross-section of the portal vein and other large veins. IDUS was useful in detecting carcinoma in situ and small tumors, in assessing the intraductal spread of the tumor and its pancreatic parenchymal invasion in mucin-producing tumors of the main duct, and in assessing the indications for surgery by revealing mural nodules in mucin-producing tumors of the ductal branches. IDUS was also useful in evaluating the feasibility of partial resection of the tumor in mucin-producing tumors of the ductal branches and pancreatic islet-cell tumors, in accurately locating multiple lesions in pancreatic islet-cell cancer, and in differentiating benign from malignant cases of localized stenosis of the main pancreatic duct related to pancreatic stenting. With IDUS, the site of pancreatic stones could be identified in order to assess the need for endoscopic treatments such as stenting of the pancreatic duct and the bile duct, and the use of pulsed-dye laser treatment under pancreatoscopy for pancreatic stones. Acute pancreatitis as a complication occurred in one of the 239 patients who underwent IDUS (0.4%). An awareness of the limitations and usefulness of IDUS in evaluating pancreatic diseases can contribute to the treatment of these conditions.
对安装有30兆赫或20兆赫换能器的导管内超声（IDUS）探头在239例胰腺疾病患者（包括48例癌症、90例黏液生成性肿瘤、7例胰岛细胞瘤、2例转移性胰腺肿瘤、7例浆液性囊腺瘤、1例胰腺畸胎瘤、3例实性囊性肿瘤、49例慢性胰腺炎、25例局灶性胰腺炎和7例胰石症）的诊断中进行了评估。探头经乳头插入主胰管。在分辨率方面，20兆赫的IDUS能够对直径小于30毫米的囊性病变和直径小于20毫米的实性病变进行成像。在血管方面，IDUS能够对门静脉和其他大静脉的整个横截面进行成像。IDUS在检测原位癌和小肿瘤、评估主胰管黏液生成性肿瘤中肿瘤的导管内扩散及其胰腺实质侵犯，以及通过揭示分支导管黏液生成性肿瘤中的壁结节来评估手术指征方面很有用。IDUS在评估分支导管黏液生成性肿瘤和胰岛细胞瘤中肿瘤部分切除的可行性、准确确定胰岛细胞癌中的多个病变位置，以及区分与胰腺支架置入相关的主胰管局限性狭窄的良恶性病例方面也很有用。使用IDUS可以确定胰石的位置，以评估诸如胰管和胆管支架置入等内镜治疗的必要性，以及在胰镜检查下对胰石使用脉冲染料激光治疗的必要性。在接受IDUS检查的239例患者中，有1例（0.4%）发生了急性胰腺炎并发症。了解IDUS在评估胰腺疾病中的局限性和有用性有助于这些疾病的治疗。
