超声造影在诊断肿块型自身免疫性胰腺炎中的临床价值
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摘要
目的探讨超声造影(CEUS)在肿块型自身免疫性胰腺炎(AIP)术前诊断及鉴别诊断中的价值。方法回顾性对比分析19例肿块型AIP与20例胰腺导管腺癌(PDAC)的CEUS表现。结果所有肿块型AIP病灶在动脉期均表现为整体高增强(n=12,63.16%)或等增强(n=7,36.84%),在延迟期呈高增强(n=8,42.11%)或等增强(n=11,57.89%)。而95.00%(n=19)的PDAC病灶在动脉期静脉期及延迟期均呈低增强(P<0.05)。结论超声造影凭借其无创、简便、可多次反复检查等优势,有助于术前诊断及鉴别诊断肿块型AIP,在临床实践中有潜在的应用价值。
Objective To evaluate the value of CEUS on preoperative diagnosis and differential diagnosis of isolated autoimmune pancreatitis(AIP).Methods In this retrospective study,the contrast-enhanced ultrasound(CEUS)features of 19 isolated AIP and 20 pancreatic ductal adenocarcinoma(PDAC)were compared.Results After the injection of contrast agents,all isolated AIP lesions showed hyper-enhancement(n=12,63.16%)or iso-enhancement(n=7,36.84%)during arterial phase,8 out of 19 lesions showing hyper-enhancement and 11 out of 19 lesions showing isoenhancement during late phase.However,most(95%)PDAC lesions showed hypoechoic enhancement during all CEUS phases(P<0.05).Conclusions CEUS is helpful in preoperative diagnosis and differential diagnosis of isolated AIP.Depending on it′s unique advantages such as non-invasive,convenient and repeatable,CEUS is of potential value in clinical practice.
Objective To evaluate the value of CEUS on preoperative diagnosis and differential diagnosis of isolated autoimmune pancreatitis(AIP).Methods In this retrospective study,the contrast-enhanced ultrasound(CEUS)features of 19 isolated AIP and 20 pancreatic ductal adenocarcinoma(PDAC)were compared.Results After the injection of contrast agents,all isolated AIP lesions showed hyper-enhancement(n=12,63.16%)or iso-enhancement(n=7,36.84%)during arterial phase,8 out of 19 lesions showing hyper-enhancement and 11 out of 19 lesions showing isoenhancement during late phase.However,most(95%)PDAC lesions showed hypoechoic enhancement during all CEUS phases(P<0.05).Conclusions CEUS is helpful in preoperative diagnosis and differential diagnosis of isolated AIP.Depending on it′s unique advantages such as non-invasive,convenient and repeatable,CEUS is of potential value in clinical practice.
引文
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[13]严昆,戴莹,王艳滨,等.超声造影对胰腺占位病变的诊断应用价值[J].中华超声影像学杂志,2006,5:361-364.
[2] KHANDELWAL A,SHANBHOGUE A K,TAKAHASHI N,et al.Recent advances in the diagnosis and management of autoimmune pancreatitis[J].AJR Am J Roentgenol,2014,202(5):1007-1021.
[3] SIDHU P S,CANTISANI V,DIETRICH C F,et al.The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound(CEUS)in Non-Hepatic Applications:Update 2017(Short Version)[J].Ultraschall Med,2018,39(2):154-180.
[4]赵一晓,吕红.自身免疫性胰腺炎的不同分型及其诊治进展[J].中国医学科学院学报,2016,6:731-734.
[5] MATSUBAYASHI H,KAKUSHIMA N,TAKIZAWA K,et al.Diagnosis of autoimmune pancreatitis[J].World J Gastroenterol,2014,20(44):16559-16569.
[6] CROSARA S,D′ONOFRIO M,De ROBERTIS R,et al.Autoimmune pancreatitis:Multimodality non-invasive imaging diagnosis[J].World J Gastroenterol,2014,20(45):16881-16890.
[7] TAKUMA K,KAMISAWA T,GOPALAKRISHNA R,et al.Strategy to differentiate autoimmune pancreatitis from pancreas cancer[J].World J Gastroenterol,2012,18(10):1015-1020.
[8]王静波,向子云,詹勇,等.自身免疫性胰腺炎与胰腺癌的CT鉴别诊断价值[J].中国CT和MRI杂志,2011(2):45-48.
[9] OMIYALE A O.Autoimmune pancreatitis[J].Gland Surg,2016,5(3):318-326.
[10]卢颖,黄光亮,谢晓燕,等.自身免疫性胰腺炎超声表现及与胰腺癌的鉴别[J].中华超声影像学杂志,2014,4:308-311.
[11] ARDELEAN M,SIRLI R,SPOREA I,et al.Contrast enhanced ultrasound in the pathology of the pancreas-a monocentric experience[J].Med Ultrason,2014,16(4):325-331.
[12] WANG Y,YAN K,FAN Z,et al.Clinical Value of ContrastEnhanced Ultrasound Enhancement Patterns for Differentiating Focal Pancreatitis From Pancreatic Carcinoma:A Comparison Study With Conventional Ultrasound[J].J Ultrasound Med,2018,37(3):551-559.
[13]严昆,戴莹,王艳滨,等.超声造影对胰腺占位病变的诊断应用价值[J].中华超声影像学杂志,2006,5:361-364.