CAJ | 학술논문

目的初步探讨正常胰腺及胰腺与位病变的超声内镜弹性成像特征及其在良恶性鉴别中的价值.方法自2009年1月至6月,对9例胰腺占位病变行EUS的患者同时进行超声内镜实时弹性成像,同时选取6例因其他病变而行EUS者的正常胰腺行超声内镜实时弹性成像作对照,按照弹性成像5分法对组织弹性成像进行评分.结果 9例胰腺占位病变患者最终诊断为胰腺癌4例,囊腺癌1例,囊腺瘤2例,局限性胰腺炎2例,其弹性成像评分:胰腺癌1例3分、3例4分,囊腺癌5分,2例囊腺瘤均为2分,局限性胰腺炎2分和3分各1例;6例正常胰腺者其弹性成像评分1分5例,2分1例.当以1、2分为良性,3～5分为恶性病变的标准进行判断时,超声内镜弹性成像对9例胰腺占位性病变良恶性鉴别有8例准确.结论胰腺良恶性组织弹性成像呈不同的图像特征,超声内镜实时弹性成像有助于胰腺良恶性病变的鉴别.
목적 초보탐토정상이선급이선여위병변적초성내경탄성성상특정급기재량악성감별중적개치.방법 자2009년1월지6월,대9례이선점위병변행EUS적환자동시진행초성내경실시탄성성상,동시선취6례인기타병변이행EUS자적정상이선행초성내경실시탄성성상작대조,안조탄성성상5분법대조직탄성성상진행평분.결과 9례이선점위병변환자최종진단위이선암4례,낭선암1례,낭선류2례,국한성이선염2례,기탄성성상평분:이선암1례3분、3례4분,낭선암5분,2례낭선류균위2분,국한성이선염2분화3분각1례;6례정상이선자기탄성성상평분1분5례,2분1례.당이1、2분위량성,3～5분위악성병변적표준진행판단시,초성내경탄성성상대9례이선점위성병변량악성감별유8례준학.결론 이선량악성조직탄성성상정불동적도상특정,초성내경실시탄성성상유조우이선량악성병변적감별.
Objective To investigate the EUS elastographic patterns of normal pancreas and focal pancreatic lesions, and its value for characterizing and differentiating between benign and malignant pancreatic tissues. Methods Between January and June 2009, 6 patients with normal pancreas and 9 patients with focal pancreatic lesions were enrolled. Real-time elastography was carried out during the conventional EUS examination. The elastographic images were scored with 1 to 5 based on the elastographic pattern. Results Nine focal pancreatic lesions were finally diagnosed as pancreatic cancer (n = 4), cyst-adenocarcinoma (n =1), cyst-adenoma (n = 2) and focal pancreatitis (n = 2), respectively. Pancreatic cancers were scored as 3(n = 1) and 4 (n = 3). Cyst-adenocarcinoma was scored as 5 and cyst-adenomas were scored both as 2,while focal pancreatitis were scored as 2 and 3, respectively. Elastographic pattern was scored as 1 (n = 5)and 2 (n = 1) in 6 normal pancreas. When scores 1 and 2 were assigned to benign lesion and 3 to 5 to malignancy, the overall diagnostic accuracy of EUS elastography for focal pancreatic lesions was 88. 9%(8/9). Conclusion There are apparent differences in elastographic patterns between benign and malignant pancreatic tissues. EUS elastography is a promising method that allows characterization and differentiation of benignancy and malignancy.