【摘要】 目的探讨内镜超声在胰岛细胞瘤定位诊断中的作用。方法对临床症状及生化检查诊断胰岛细胞瘤的患者15例分别行腹部B超、CT、选择性动脉造影(DSA)和内镜超声检查(EUS),通过与手术和病理结果对照,分析各影像学检查在胰岛细胞瘤定位诊断中的意义。结果经手术及病理证实为胰岛细胞瘤15例(包含16个病灶),各检查诊断准确率分别为：腹部B超20．0%(3/15),CT 33．3% (5/15),DSA 64．3%(9/14)和EUS 86．7%(13/15)。EUS发现的14个病灶中,表现低回声者10个,中等回声者1个,中等偏强回声者3个,病变边界均清楚,回声均匀。EUS发现病变小于2 cm者10个,最小为0．5 cm。EUS误判断的2例中,1例位于胰尾与脾门交界处,另1例胰腺内有2个病变,而EUS仅发现了1个。结论EUS对胰岛细胞瘤定位诊断的敏感性明显优于B超、CT、DSA等。更多还原

【Abstract】 Objective To study on the effectiveness of endoscopic ultrasonography(EUS)in detec- ting insulinoma preoperatively.Methods Fifteen patients with clinical and biochemical signs of insulinoma were examined by EUS using a radial-scanning ultrasound endoscope and abdominal ultrasonography,CT, DSA prior to surgery.The outcome was evaluated on the basis of surgery and examination of the resected specimens.Results Fifteen patients with 16 lesions of insulinoma were identified by surgery and pathology. The aceuraey of diagnosis with EUS was 13/15(86.7%),and that with B-US,CT,DSA was 3/15(20%), 5/15(33.3%),9/14(64.3%)respectively.In the 14 lesions identified by EUS,10 lesions were depicted to be hypoechogenic,1 lesion was isoechogenic and 3 lesions were hyperechogenie.All 14 lesions were well demarcated and surrounded by normal pancreatic tissue.The minimum size of the lesion visualized by EUS was 0.5cm.Ten lesions were correctly detected by EUS with size of 0.5～2.0cm.EUS missed diagnosis in 2 lesions not for their small size.EUS falsely indicated a 10mm lesion from two lesions inside the head of pancreas.One lesion outside the pancreatic tail and one lesion in the pancreatic head were missed by EUS in another case.Conclusion EUS is superior in assessing the location of pancreatic insulinoma than other ima- ging methods such as B-US,CT,DSA.更多还原