超声手法筛查中老年人胰头-壶腹周围病变价值.docVIP

超声手法筛查中老年人胰头-壶腹周围病变价值【摘要】 目的 总结分析超声探头加压旋转对于胰头-壶腹周围病变的显示特点,使超声波检查在中老年人筛查病灶方面更加客观、准确。方法 回顾性总结在查体中筛查出90例胰头-壶腹周围病变患者,其中男性69例,女性21例。采用超声探头加压旋转检查手法与不用加压旋转手法比较,根据内部及边缘回声,图像质量,将检查结果与手术、超声造影对比做为金标准。结果 90例病灶中,不用探头加压旋转手法敏感性65.3%,特异性33.3%,准确性60.0%;用探头加压旋转手法敏感性93.0%,特异性81.0%,准确性93.3%。结论 使用超声探头加压旋转法诊断胰腺-壶腹区病变,可明显增强诊断者的信心,但当不用此法又无相应的临床背景资料支持时,筛查的阳性率就相对下降。 【关键词】 胰头-壶腹周围;超声探头;加压旋转;筛查;病变 【Abstract】 Objective To summarize manifestation features of pressure rotation of ultrasonic probe in screening peripheral lesion of head and ampulla of pancreas,and to find more objective and exact method in screening lesions in middle-aged and elderly people.Methods 90 patients with peripheral lesion of head and ampulla of pancreas screened in medical examination were retrospectively summarized,including 69 males and 21 females.According to a gold standard of result of operation and ultrasonic contrast,interior and limbic echo and image quality by pressure rotation method and by normal examination method were compared and analysed.Results Of 90 patients,the sensitivity,specificity and accurate rate by pressure rotation of ultrophonic probe were 93.0%,81.0% and 93.3% respectively.While those by normal examination method were 65.3%,33.3% and 60.0% respectively.Conclusion Pressure rotation of ultrophonic probe is a confirmative method in screening screening peripheral lesion of head and ampulla of pancreas. 【Key words】 Peripheral lesion of head and ampulla of pancreas;Ultrophonic probe;Partition rotation;Screening;Lesion 超声检查是常规查体首选手段,尤其是在中老年人群体中,快速经济、灵敏、无创是其优点,但其准确性在很大程度上依赖于手法和经验。胰头-壶腹周围检查是常规超声检查的难点[1-2]。近年来发展的新技术如胰镜、内镜超声、门静脉内超声等具有先进性及优越性的检查设备对胰头-壶腹周围病灶早期诊断已有了明显提高,但是鉴于其侵袭性及价格昂贵,技术手法复杂,临床应用尚不普及,在临床工作中特别是在疗养查体的基层医疗单位是极其不适用的,应用超声探头加压旋转手法使图像质量提高,达到诊断效果,我们对此做了初步探讨。 1材料与方法 1.1临床资料2004年9月―2009年10月,共1 500例查体者接受了超声检查,男800例,女700例;年龄45～70岁,平均(58.3±3.47)岁;其中经手术病理或造影证实的90个病变纳入本研究,占位病变包括72个病灶(胆总管末段结石17个,胰管结石13个,胰头癌11个,壶腹部癌9个,胰腺囊肿22个),18个非均匀脂肪胰局灶样变。 1.2仪器与方法采用LIQK 700,500彩超仪,经腹探头频率3.5 MHz。检查前嘱患者