内镜超声在胰腺内分泌肿瘤——胰岛素瘤诊断中价值.docVIP

内镜超声在胰腺内分泌肿瘤——胰岛素瘤诊断中价值 内镜超声在胰腺内分泌肿瘤——胰岛素瘤诊断中的价值 2011-07-20 诸琦　袁耀宗　田小年　郁忠勤　吴云林　江石湖　罗邦尧 摘　要：目的　和传统影像学检查方法比较，评价内镜超声(EUS)在胰腺内分泌肿瘤——胰岛素瘤术前定位诊断中的临床价值。方法　6例临床疑为胰岛素瘤的患者术前行内镜超声、腹部超声(US)以及计算机断层扫描(CT)检查，同时和手术中的发现及手术后的病理结果相对比。结果　手术共发现胰腺占位病灶7个，术前EUS、CT、US对6例患者胰腺占位病灶的检出率分别为85.7%(6/7)、57.1%(4/7)和14.3%(1/7)；而和手术后病理结果比较，EUS对胰岛素瘤的诊断符合率为83.3%(5/6)；但对胰腺病灶的部位以及大小的诊断均基本和手术发现相符。结论　EUS对胰腺占位病灶的术前定位诊断优于传统的影像学检查，是一种临床可行且较有价值的检查方法。 关键词：内分泌腺肿瘤； 胰岛素瘤； 腔内超声检查 Evaluation of the contribution of endoscopic ultrasonography to the diagnosis of pancreatic endocrine tumor——insulinoma ZHU Qi　YUAN Yaozong　TIAN Xiaonian　et al （Department of Gastroenterology,Ruijin Hospital,Shanghai Second Medical University,Shanghai 200025） Abstract：Objective　To assess the clinical diagnostic value of endoscopic ultrasonography (EUS) in preoperative localization of pancreatic endocrine neoplasm——insulinoma by comparing with the conventional imaging procedures. Methods　Six patients with insulinoma diagnosed by clinical and laboratory findings were assessed with US, CT and EUS to detect the pancreatic lesions before surgical intervention. All the cases then received laporatomy and tumors were examined by histological study. Results　In six cases, seven lesions were found in pancreas by surgical procedures, the diagnostic detectability of pancreatic neoplasms by US, CT and EUS being 14.3% (1/7), 57.1% (4/7) and 85.7% (6/7) respectively. The diagnostic accuracy of insulinoma by EUS was 83.3% (5/6) as compared with histological study. However, the diagnostic detectability of site and size of pancreatic lesions by EUS was in accordance with that of surgical results. Conclusions　EUS is superior to conventional image examinations in preoperative localization of pancreatic neoplasma and is a feasible and effective procedure in clinical diagnosis of insulinoma. Key words：Endocrine gland neoplasms; Insulinoma; Endosonography▲ 　　胰岛素瘤(insulinoma)是胰腺内分泌肿瘤中常见的良性肿瘤，临床上根据患者的症状以及一些血液生化检测虽能对该疾病作出基本明确的定性诊断，但传统的影像学检查方法对胰岛素瘤的定位诊断仍欠满意。因