慢性胰腺炎的超声内镜诊断

对３０例慢性胰腺炎作体表腹部超声（ＵＳ）。内镜逆行胰胆管造影（ＥＲＣＰ）和超声内镜（ＥＵＳ）对比检查。对胰管、胰实质回声、胰腺形态、胰石及囊肿等特征的研究表明：①ＥＵＳ能清楚地显示主胰管及其扩张程度、胶管狭窄部位、胰石和囊肿情况，ＥＵＳ对胰石和囊肿的发现率优于ＥＲＣＰ（Ｐ＜０．０１），ＥＵＳ对分枝胰管的显示率低于ＥＲＣＰ（Ｐ＜０．０１）；②ＥＵＳ显示扩张的主胰管与ＵＳ比较无差别（Ｐ＞０．０５），对狭窄的主胰管及分枝胰管的显示率和胰石的显示率均高于ＵＳ（Ｐ＜０．０１），对囊肿的显示二者无差别；③ＥＵＳ能对胰实质回声改变进行分型诊断；④年龄增长和ＥＵＳ非连续切面影响对慢性胰腺炎的诊断；⑤ＥＵＳ与ＵＳ和／或ＥＲＣＰ联合检查可提高慢性胰腺炎的正确诊断率．

Diagnosis of Chronic Pancreatitis by Endoscopic Ultrasonography

With the method of endoscopic ultrasonography(EUS), ERCP, and conventional ultrasonography(US), 30 patients with chronic pancreatitis were examined.Results were as follows:1. EUS findings of the main pancreatic duct (MPD) were consistent with ERCP findings. EUS findings of the pancreatic stones and pancreatic cysts were better than ERCP findings.2. EUS findings of the dilated MPD and pancreatic cysts were consistent with US findings. EUS was highly superior to US in the diagnosis of stenosis of MPD, the branch of pancreatic duct and pancreatic stones.3. High echo spots and roughnesses of internal echo pattern of the pancreas were easy to detect and irregularities of pancreatic margin were well delined in EUS. 4. Midly rough internal echo and high echo spots around the MPP were seen in normal high age group. 5. EUS combined with US and/or ERCP examination can raise the diagnostic accurancy of chronic pancreatitis.