目的:恶性肿瘤的检测是治疗导管内乳头状黏液性肿瘤(IPMN)的主要关注点。壁画结节(MN)的高度,使用内窥镜超声(EUS)和计算机断层扫描(CT)进行估计,已被认为对预测恶性IPMN至关重要。目前,仅使用CT或EUS进行监测是否足以检测MNs尚不清楚.本研究旨在比较CT和EUS在IPMN中检测MN的能力。
方法:这个多中心,我们在11所日本大专院校进行了回顾性观察研究.在CT和EUS检查后接受MN手术切除IPMN的患者有资格参加。检查了CT和EUS之间的MN检出率。
结果:接受术前EUS和CT检查的240例患者经病理证实为MNs。EUS和CT的MN检出率分别为83%和53%,分别(p<0.001)。此外,无论形态类型如何,EUS的MN检出率均显著高于CT(76%vs.分支导管型IPMN占47%;90%vs.混合IPMN中的54%;98%与在主管型IPMN中为56%;p<0.001)。Further,经病理证实的MNs≥5mm在EUS上比在CT上更常见(95%与76%,p<0.001)。
结论:EUS在IPMN中检测MN优于CT。EUS监测对于检测MNs至关重要。
OBJECTIVE: The detection of malignancy is a major concern in the management of intraductal papillary mucinous neoplasm (
IPMN). The height of the mural nodule (MN), estimated using endoscopic ultrasound (EUS) and computed tomography (CT), has been considered crucial for predicting malignant IPMN. Currently, whether surveillance using CT or EUS alone is sufficient for detecting MNs remains unclear. This
study aimed to compare the ability of CT and EUS to detect MNs in
IPMN.
METHODS: This multicenter, retrospective observational
study was conducted in 11 Japanese tertiary institutions. Patients who underwent surgical resection of IPMN with MN after CT and EUS examinations were eligible to participate. The MN detection rates between CT and EUS were examined.
RESULTS: Two-hundred-and-forty patients who underwent preoperative EUS and CT had pathologically confirmed MNs. The MN detection rates of EUS and CT were 83% and 53%, respectively (p < 0.001). Additionally, the MN detection rate of EUS was significantly higher than that of CT regardless of morphological type (76% vs. 47% in branch-duct-type IPMN; 90% vs. 54% in mixed
IPMN; 98% vs. 56% in main-duct-type
IPMN; p < 0.001). Further, pathologically confirmed MNs ≥5 mm were more frequently observed on EUS than on CT (95% vs. 76%, p < 0.001).
CONCLUSIONS: EUS was superior to CT for the detection of MN in
IPMN. EUS surveillance is essential for the detection of MNs.