Efficacy of diagnosing intraductal papillary mucinous neoplasm with mural nodules by contrast-enhanced endoscopic ultrasound using time-intensity curve analysis with a new support program: A multicenter retrospective study (with video).
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引用次数: 0
Abstract
Background/objectives: Preoperative diagnosis of the pathological grade of intraductal papillary mucinous neoplasms (IPMN) is challenging. This study aimed to evaluate the accuracy of contrast-enhanced endoscopic ultrasound (CE-EUS) using time-intensity curve (TIC) analysis with a newly developed support program to differentiate between low-grade dysplasia (LGD) and high-grade dysplasia (HGD)/invasive carcinoma (IC) in IPMN.
Methods: This study retrospectively analyzed 32 patients who underwent CE-EUS using the support program for TIC analysis and IPMN resection (LGD: 17, HGD/IC: 15) at two medical centers. The TIC parameters of mural nodules (MN) were compared between the LGD and HGD/IC groups, and the diagnostic accuracies of the TIC parameters were evaluated.
Results: The MN/pancreatic parenchyma contrast ratio was significantly higher in the HGD/IC group than in the LGD group (1.53 vs. 0.99; P < 0.0001), and the diagnostic abilities of the contrast ratio were as follows: sensitivity, 67 %; specificity, 100 %; and accuracy, 84 %. There were no differences in the echo intensity reduction rate of the MNs between the two groups (HGD/IC, 61.6 vs. 61.2, 0.99; P = 0.421), and the diagnostic abilities of the reduction rate were as follows: sensitivity, 93 %; specificity, 41 %; and accuracy, 66 %.
Conclusions: The contrast ratio calculated using TIC analysis with the support program is potentially useful for differentiating between IPMNs with LGD and those with HGD/IC.
背景/目的：导管内乳头状粘液瘤（IPMN）的术前病理分级诊断具有挑战性。本研究旨在评估对比增强内镜超声（CE-EUS）的准确性，使用时间强度曲线（TIC）分析和新开发的支持程序来区分IPMN中低级别异常增生（LGD）和高级别异常增生(HGD)/浸润性癌（IC）。方法：本研究回顾性分析了两家医疗中心32例使用支持程序进行TIC分析和IPMN切除术的CE-EUS患者（LGD: 17, HGD/IC: 15）。比较LGD组和HGD/IC组壁结节（MN）的TIC参数，并评价TIC参数诊断的准确性。结果：HGD/IC组MN/胰腺实质对比度明显高于LGD组（1.53 vs. 0.99, P < 0.0001），其诊断能力如下：敏感性67%；特异性，100%；准确率为84%。两组间MNs回声强度降低率差异无统计学意义（HGD/IC, 61.6 vs. 61.2, 0.99; P = 0.421），对降低率的诊断能力如下：敏感性，93%；特异性，41%；准确率为66%。结论：使用TIC分析和支持程序计算的对比度可能有助于区分合并LGD的ipmn和合并HGD/IC的ipmn。
期刊介绍：
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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