上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (10): 1217-.doi: 10.3969/j.issn.1674-8115.2010.10.008

• 论著（临床研究） • 上一篇    下一篇

超声造影在胰腺癌可切除性评估中的价值

吴春华, 李凤华, 方 华, 顾莉红, 韩蕊君, 王筱玲   

  1. 上海交通大学 医学院附属仁济医院超声医学科, 上海 200127
  • 出版日期:2010-10-25 发布日期:2010-10-27
  • 作者简介:吴春华（1975—）, 女, 主治医师, 硕士生；电子信箱: tracy_wu310@sina.com。
  • 基金资助:

    上海市重点学科建设项目资助（S30203）

Value of contrast-enhanced ultrasound in evaluating resectability of pancreatic carcinoma

WU Chun-hua, |LI Feng-hua, FANG Hua, GU Li-hong, HAN Rui-jun, WANG Xiao-ling   

  1. Department of Ultrasound in Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2010-10-25 Published:2010-10-27
  • Supported by:

    Shanghai Leading Academic Discipline Project, S30203

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摘要：

目的 利用超声造影检查了解胰腺癌侵犯周围血管的情况，探讨术前超声造影对胰腺肿瘤可切除性的评估价值。方法 收集45例术前超声造影检查资料完整且经术后病理学检查证实为胰腺癌患者的临床资料。回顾并记录术前超声造影检查显示的胰周大血管受侵犯情况、根据分型标准对肿块可切除性（根治性或姑息性手术）的评价结果以及最终手术方式选择情况，分析术前超声造影评估胰腺癌肿块可切除性的阳性和阴性预测值以及敏感性和特异性。结果 术前超声造影检查显示，45例患者共67条胰周大血管受侵，其中腹腔动脉、肠系膜上动脉、肠系膜上静脉、肝总动脉的受侵率分别为31.1%、22.7%、22.2%和22.2%。术前超声造影评估可切除肿块20例，实际切除（根治性手术）17例，阳性预测值85.0%；评估不可切除肿块25例，实际未切除（姑息性手术）20例，阴性预测值80.0%（20/25）；判断肿瘤可切除性的敏感性和特异性分别为77.3%和86.9%。结论 超声造影可较为准确地反映胰周大血管受侵犯情况，对于胰腺癌术前可切除性评估具有一定的参考价值。

关键词: 胰腺癌, 超声造影, 可切除性

Abstract:

Objective To observe situation of vessels invaded by pancreatic carcinoma by using contrast-enhanced ultrasound (CEUS) and to assess the resectability of pancreatic carcinoma. Methods Forty-five patients having complete CEUS data and diagnosed as pancreatic carcinoma by pathologic examination of surgery specimen were selected. The large peripanceatic vessels invasion situation observed by CEUS before operation was recorded and reviewed. According to classification standard in evaluating resectability of tumor (radical or palliative resection) and final surgery selection, positive and negative predictive value, sensitivity, and specificity of CEUS before operation evaluating the resectability of pancreatic carcinoma were analyzed. Results According to CEUS data before operation, 67 peripancreatic vessels of 45 patients were invaded, among which the invasion rates of celiac artery, superior mesenteric artery, superior mesenteric vein, and hepatic artery were 31.1%, 22.7%, 22.2%, and 22.2%, respectively. Of all the 20 patients who were considered to be resectable according to the CEUS evaluation，17 underwent radical resection. The positive predictive value was 85.0% (17/20). Among the remaining 25 patients who were considered unresectable on the basis of CEUS findings, 20 underwent palliative resection. The negative predictive value was 80.0% (20/25). The sensitivity and specificity of tumor resectability prediction by CEUS were 77.3％ and 86.9％ respectively. Conclusion CEUS may provide definite value in investigating the peripancreatic vessels invasion, which has the reference value in evaluating resectability of pancreatic carcinoma.

Key words: pancreatic carcinoma, contrast-enhanced ultrasound, resectability