CAJ | 학술논문

目的探讨谐波造影增强超声内镜（CH-EUS）在诊断胰腺癌中的作用。方法选择胰腺占位病变患者为研究对象，以超声内镜引导下细针穿刺（EUS-FNA）或组织病理学及随访结果作为最终诊断，与CH-EUS诊断比较，评价CH-EUS诊断胰腺癌的准确度，并分析CH-EUS在不同胰腺肿瘤中的图像特点。结果共76例患者入选，平均年龄（53．1±14．2）岁，其中胰腺癌35例，局灶肿块型炎症21例，胰腺神经内分泌肿瘤10例，囊腺瘤6例，胰管内乳头状产黏蛋白肿瘤4例。肿瘤最大直径平均（3．4±1．4）cm，＜2 cm者18例。CH-EUS诊断胰腺癌的灵敏度97．1％，特异度92．9％，阳性预测值91．7％，阴性预测值97．5％。行EUS-FNA 64例，CH-EUS联合FNA对胰腺癌检查的灵敏度达到100％。结论 CH-EUS可安全、简便、准确地显示胰腺病变的血供情况，对于胰腺癌诊断的敏感度、特异度均较高，是EUS-FNA的有力补充，值得临床推广应用。
목적탐토해파조영증강초성내경（CH-EUS）재진단이선암중적작용。방법선택이선점위병변환자위연구대상，이초성내경인도하세침천자（EUS-FNA）혹조직병이학급수방결과작위최종진단，여CH-EUS진단비교，평개CH-EUS진단이선암적준학도，병분석CH-EUS재불동이선종류중적도상특점。결과공76례환자입선，평균년령（53．1±14．2）세，기중이선암35례，국조종괴형염증21례，이선신경내분비종류10례，낭선류6례，이관내유두상산점단백종류4례。종류최대직경평균（3．4±1．4）cm，＜2 cm자18례。CH-EUS진단이선암적령민도97．1％，특이도92．9％，양성예측치91．7％，음성예측치97．5％。행EUS-FNA 64례，CH-EUS연합FNA대이선암검사적령민도체도100％。결론 CH-EUS가안전、간편、준학지현시이선병변적혈공정황，대우이선암진단적민감도、특이도균교고，시EUS-FNA적유력보충，치득림상추엄응용。
Objective To evaluate the diagnostic accuracy of contrast-enhanced harmonic EUS (CH-EUS)for pancreatic cancer.Methods Patients with pancreatic occupying lesion underwent CH-EUS with ultrasonic contrast medium Sonovue.Pathological diagnoses by EUS-FNA or surgery and the follow-up results were made as the final diagnosis to evaluate the accuracy of CH-EUS for pancreatic cancer.Character-istics of CH-EUS in different pancreatic tumors were analysed.Results A total of 76 patients were en-rolled,with an average age of 53. 1 ±14. 2.Thirty-five were finally diagnosed as having pancreatic cancer, 21 local mass-type pancreatitis,10 pancreatic neuroendocrine tumor,6 cystadenoma,4 intraductal papillary mucinous neoplasm.Tumor diameter was 3. 4 ±1. 4 cm and there were 18 less than 2 cm.The sensitivity and specificity,positive and negative predictive value of CH-EUS for pancreatic cancer was 97. 1%, 92. 9%,91. 7% and 97. 5% respectively.The sensitivity was 100% combined with FNA.Conclusion CH-EUS is safe,convenient for pancreatic cancer with high accuracy and can be used as an additional diag-nostic method to EUS-FNA.