PDF(Pubmed)
Abstract：
Pancreatic cystic lesions (PCLs) have increased in prevalence due to the increased usage and advancements in cross-sectional abdominal imaging. Current diagnostic techniques cannot distinguish between PCLs requiring surgery, close surveillance, or expectant management. This has increased the morbidity and healthcare costs from inappropriately aggressive and conservative management strategies. Endoscopic ultrasound (EUS) needle-based confocal laser endomicroscopy (nCLE) allows for microscopic examination and delineation of the surface epithelium of PCLs. Landmark studies have identified characteristics distinguishing various types of PCLs, confirmed the high diagnostic yield of EUS-nCLE (especially for PCLs with an equivocal diagnosis), and shown that EUS-nCLE helps to change management and reduce healthcare costs. Refining procedure technique and reducing procedure length have improved the safety of EUS-nCLE. The utilization of artificial intelligence and its combination with other EUS-based advanced diagnostic techniques would further improve the results of EUS-based PCL diagnosis. A structured training program and device improvements to allow more complete mapping of the pancreas cyst epithelium will be crucial for the widespread adoption of this promising technology.
摘要：
由于横截面腹部成像的使用和进步，胰腺囊性病变（PCL）的患病率增加。当前的诊断技术无法区分需要手术的PCL，密切监视,或预期管理。由于不适当的积极和保守的管理策略，这增加了发病率和医疗保健成本。内窥镜超声（EUS）基于针头的共聚焦激光显微内窥镜（nCLE）允许对PCL的表面上皮进行显微镜检查和勾画。地标研究已经确定了区分各种类型PCL的特征，证实了EUS-nCLE的高诊断率（特别是对于诊断模棱两可的PCL），并表明EUS-nCLE有助于改变管理并降低医疗保健成本。改进程序技术和减少程序长度提高了EUS-nCLE的安全性。人工智能的利用及其与其他基于EUS的先进诊断技术的结合将进一步改善基于EUS的PCL诊断的结果。结构化的训练计划和设备改进以允许更完整的胰腺囊肿上皮作图对于广泛采用这种有前途的技术至关重要。
