超声内镜对胆胰疾病诊断价值的探讨

目的 探讨超声内镜（EUS）对胆胰疾病的诊断价值。方法 采用超声胃镜（频率为7．5MHz和20Mnz），应用水囊法结合水充盈法，对54例临床疑为胆胰病变的患者进行EUS检查，并与腹部B超、CT及ERCP比较。结果 EUS、US、CT、ERCP对胆胰疾病诊断的阳性率分别为92．6％（50/54）、57．4％（31／54）、64．8％（35／54）及76．2％（32／42）。EUS对胰腺癌诊断的阳性率达100％。高于腹部B超、CT及ERCP；EUS对胆总管结石及慢性胰腺炎的准确率分别为100％和88．9％。结论 EUS对胆胰疾病的诊断率高于腹部B超，CT及ERCP影像检查，尤其对胆管扩张病因的定位及定性诊断均有较大的诊断价值。

Application of endoscopic ultrasonography in the diagnosis of choledochopancreatic diseases

Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) in diagnosing choledochal and pancreatic diseases. Methods EUS was performed in 54 patients with suspected choledochol and pancreatic diseases. At the same time, US (conventional ultrasonography), CT (computerized tomography) and ERCP (endoscopic retrograde cholangiopancreatography ) were carried out to compare the accuracy of EUS. Results EUS had a high accuracy in the diagnosis of chledochal and pancreatic diseases than that of US,CT,and ERCP. The overall positive rate of EUS, US, CT and ERCP were 92.6%,57.4%,64.8%, 76.2% , respectively. EUS detected all lesions of pancreatic carcinoma,and the diagnostic accuracy for pancreatic carcinoma was 100%, which was higher than that of US,CT and ERCP. In chronic pancreatitis, the positive rates of EUS, US,CT and ERCP were 88.9%,55.6%, 55.6%, 66.7% respectively. The positive rate of EUS for choledocholithiasis was 100%. Conclusion EUS has a high value in the diagnosis of choledochal and pancreatic diseases.