超声内镜与CT对胰腺及壶腹部周围肿瘤的术前诊断价值

目的评估超声内镜(endoscopic ultrasonography,EUS)和CT对胰腺及壶腹部周围肿瘤的术前诊断价值。方法回顾性分析33例胰腺及壶腹部肿瘤患者术前EUS、CT资料,与手术探查及术后病理结果对照,从肿瘤大小、部位等角度筛选出影响EUS准确性的因素。结果 EUS在判断胰周脂肪浸润、胆管扩张、胰周脏器侵犯、血管侵犯等方面敏感性、特异性与CT的差异无统计学意义(P>0．05);EUS在胰管扩张及淋巴结转移方面的诊断价值优于CT(P=0．039和P=0．004); EUS判断胰周脂肪浸润和胰周脏器侵及的准确性与肿瘤大小有关(P=0．015和P=0．022),判断胰管扩张的准确性与肿瘤部位有关(P<0．001)。结论 EUS对胰腺及壶腹部周围肿瘤诊断的临床价值很高,结合CT检查有助于加强对患者术前评价的认识。

Endoscopic ultrasonography and CT in the preoperative diagnosis of pancreatic and periampullary neoplasms

Objective To compare EUS and CT for preoperative diagnosis of pancreatic and periampullary neoplasms. Methods In this study, 33 cases of pancreatic and periampullary neoplasms underwent preoperative EUS and CT evaluation before receiving a surgery. Results were compared with pathological findings. Logistic regression was used to analyze the correlation between the accuracy of EUS and the size and site of the tumors. Results there was no significant difference in sensitivity and specificity between EUS and CT in peripancreatic fat infiltration, bile duct dilation, peripancreatic organic invasion and vascular invasion ( P > 0. 05 ). For detection of pancreatic duct dilation and lymph node metastasis, EUS was better than CT ( P=0.039,P=0.004). The accuracy of EUS in determing peripancreatic fat infiltration and organic invasion was correlated with tumor size (P=0.015,P=0.022) , pancreatic duct dilation was correlated with the location of tumors ( P < 0. 001). Conclusion EUS is of high clinical value in the diagnosis of pancreatic and periampullary neoplasms. A combination of EUS and CT is better than EUS only for preoperative evaluation.