Tissue harmonic versus contrast-enhanced harmonic endoscopic ultrasonography for the diagnosis of pancreatic tumors: Prospective multicenter study

被引：14

作者：

Omoto, Shunsuke ^{[1
]}

Kitano, Masayuki ^{[1
,5
]}

Fukasawa, Mitsuharu ^{[6
]}

Ashida, Reiko ^{[3
,5
]}

Kato, Hironari ^{[7
]}

Shiomi, Hideyuki ^{[8
]}

Sugimori, Kazuya ^{[9
]}

Kanno, Atsushi ^{[10
,12
]}

Chiba, Yasutaka ^{[2
]}

Takano, Shinichi ^{[6
]}

Yamamoto, Naoki ^{[7
]}

Ezaki, Takeshi ^{[8
]}

Miwa, Haruo ^{[9
]}

Yokomura, Akitaka ^{[4
]}

Hoshikawa, Masato ^{[4
]}

Tanaka, Takamitsu ^{[11
]}

Kudo, Masatoshi ^{[1
]}

机构：

[1] Kindai Univ, Dept Gastroenterol & Hepatol, Higashiosaka, Osaka, Japan

[2] Kindai Univ, Fac Med, Clin Res Ctr, Div Biostat, Higashiosaka, Osaka, Japan

[3] Osaka Int Canc Inst, Dept Canc Survey & Gastrointestinal Oncol, Osaka, Japan

[4] Kishiwada Tokushukai Hosp, Dept Gastroenterol, Osaka, Japan

[5] Wakayama Med Univ, Dept Internal Med 2, Sch Med, 811-1 Kimiidera, Wakayama 6418509, Japan

[6] Univ Yamanashi, Fac Med, Dept Internal Med 1, Kofu, Yamanashi, Japan

[7] Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci, Okayama, Japan

[8] Kobe Univ, Dept Internal Med, Div Gastroenterol, Grad Sch Med, Kobe, Hyogo, Japan

[9] Yokohama City Univ, Gastroenterol Ctr, Med Ctr, Yokohama, Kanagawa, Japan

[10] Tohoku Univ, Div Gastroenterol, Grad Sch Med, Sendai, Miyagi, Japan

[11] Saiseikai Matsusaka Hosp, Dept Internal Med, Matsusaka, Mie, Japan

[12] Jichi Med Univ, Dept Med, Div Gastroenterol, Shimotsuke, Tochigi, Japan

来源：

DIGESTIVE ENDOSCOPY | 2022年 / 34卷 / 01期

关键词：

contrast‐ enhanced harmonic endoscopic ultrasonography; pancreatic carcinoma; FINE-NEEDLE-ASPIRATION; QUANTITATIVE PERFUSION ANALYSIS; DIFFERENTIAL-DIAGNOSIS; SOLID LESIONS; ULTRASOUND; EUS; ACCURACY; MASSES; NEOPLASMS;

D O I：

10.1111/den.13944

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives This prospective multicenter study aimed to assess and compare the accuracy of tissue harmonic endoscopic ultrasonography (TH-EUS) and contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for differentiating pancreatic carcinoma from other pancreatic tumors. Methods Consecutive patients with solid pancreatic tumors were prospectively enrolled between August 2013 and December 2014. To assess the accuracy of TH-EUS and CH-EUS, we compared four parameters of TH-EUS (fuzzy edge, irregular periphery, hypoechogenicity, and heterogeneous internal echogenicity) and four parameters of CH-EUS (hypoenhancement and heterogeneous enhancement in the early and late phases, respectively) to investigate which parameter of each method was most suitable to diagnose pancreatic carcinomas. Interobserver agreement and the diagnostic ability of pancreatic carcinoma using TH-EUS and CH-EUS were assessed and compared. Results A total of 204 patients were enrolled. For the diagnosis of pancreatic carcinoma, interobserver agreement by experts and nonexperts was 0.33-0.50 and 0.35-0.50 for TH-EUS, respectively, and 0.72-0.74 and 0.20-0.54 for CH-EUS, respectively. Irregular periphery was the most accurate diagnostic parameter among TH-EUS findings for differentiating pancreatic carcinomas, with sensitivity, specificity, and accuracy of 95.0%, 42.9%, and 78.9%, respectively. Late phase hypoenhancement was the most accurate diagnostic parameter among CH-EUS findings for differentiating pancreatic carcinomas, with sensitivity, specificity, and accuracy of 90.8%, 74.6%, and 85.8%, respectively. The accuracy of CH-EUS (late phase hypoenhancement) for diagnosis of pancreatic carcinoma was significantly higher than that of TH-EUS (irregular periphery) (p < 0.001). Conclusion In comparison with TH-EUS, CH-EUS increased the diagnostic ability and reproducibility for the diagnosis of pancreatic carcinoma. UMIN (000011124).

引用

页码：198 / 206

页数：9

共 31 条

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