2023 年第 4 期 第 18 卷

超声内镜联合腹部CT/磁共振成像对胰腺占位性病变良恶性的诊断价值

Diagnostic value of endoscopic ultrasonography combined with abdominal CT/magnetic resonance imaging in benign or malignant pancreatic space-occupying lesions

作者：郭蒙沈娜思刘英豪谯敏

英文作者：Guo Meng Shen Nasi Liu Yinghao Qiao Min

单位：重庆医科大学附属第一医院消化内科，重庆400010

英文单位：Department of Gastroenterology the First Affiliated Hospital of Chongqing Medical University Chongqing 400010 China

关键词：胰腺占位；超声内镜；CT/磁共振成像

英文关键词：Pancreaticspace-occupying;Endoscopicultrasonography;CT/magneticresonanceimaging

• 摘要：

• 目的 探讨超声内镜(EUS)联合腹部CT/磁共振成像（MRI）对胰腺占位性病变良恶性的诊断价值。方法 选取2019年8月至2022年8月于重庆医科大学附属第一医院经腹部CT/MRI检查发现的胰腺占位性病变患者107例，所有患者均经外科手术后病理检查或EUS引导下细针穿刺后病理检查明确诊断，按照病理检查结果分为胰腺恶性占位组（84例）和胰腺良性占位组（23例）。比较2组患者临床特征的差异。比较EUS、腹部CT/MRI以及EUS联合腹部CT/MRI检查对胰腺占位性病变良恶性诊断的准确度、敏感度、特异度、阳性预测值和阴性预测值。结果 胰腺恶性占位组胰腺占位≥2 cm、穿刺次数≥3次患者的比例、糖类抗原19-9和糖类抗原72-4的水平均高于胰腺良性占位组，差异均有统计学意义(均P＜0.05)。EUS联合腹部CT/MRI检测诊断胰腺恶性占位的准确度、阴性预测值均高于EUS和腹部CT/MRI单独检测（98.13%比92.52%、82.24%；92.00%比74.19%、56.25%）。结论 EUS联合腹部CT/MRI检查可提高胰腺恶性占位的检出率，对胰腺恶性占位的早诊断和早治疗有一定意义。

• Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS) combined with abdominal CT/magnetic resonance imaging(MRI) in benign or malignant pancreatic space-occupying lesions. Methods From August 2019 to August 2022, 107 patients with pancreatic space-occupying lesions detected by CT/MRI in the First Affiliated Hospital of Chongqing Medical University were selected. All patients were diagnosed by postoperative pathological examination or pathological examination after fine needle aspiration guided by EUS. Patients were divided into pancreatic benign space-occupying group (84 cases) and pancreatic malignant space-occupying group (23 cases) according to pathological examination results. The differences of clinical characteristics were compared between the two groups. The differences of accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EUS, abdominal CT/MRI and EUS combined with abdominal CT/MRI were compared. Results The proportions of patients with pancreatic space-occupying ≥2 cm, times of aspiration ≥3, and levels of cancer antigen 19-9 and cancer antigen 72-4 in the pancreatic malignant space-occupying group were higher than those in the pancreatic benign space-occupying group (all P＜0.05). The accuracy and negative predictive value of EUS combined with abdominal CT/MRI were all higher than those of EUS, abdominal CT/MRI separately （98.13% vs 92.52%, 82.24%；92.00% vs 74.19%, 56.25%）. Conclusion EUS combined with abdominal CT/MRI can improve detection rate of pancreatic malignant space-occupying, with certain significance for early diagnosis and treatment of pancreatic malignant space-occupying.