在常见胆道扩张中内镜超声波的诊断产量:真正的突破
A I Ferreira1,2,3, S Xavier4,5,6, F Dias de Castro4,5,6
1Gastroenterology Department, Hospital Senhora da Oliveira - Guimarães, Rua dos Cutileiros, Creixomil, 4835-044, Guimarães, Portugal. ai.voferreira@gmail.com.
Digestive diseases and sciences
|September 28, 2024
概括
内镜超声波 (EUS) 在初始测试呈阴性结果时有效诊断普通胆道 (CBD) 扩张. 对于患有黄或腹痛等症状的老年患者来说尤其有用.
科学领域:
- 胃肠病学 胃肠病学
- 诊断成像 诊断成像 诊断成像
- 医学诊断 医学诊断 医学诊断
背景情况:
- 内镜超声波 (EUS) 在评估患有普通胆道 (CBD) 扩张的患者中起着至关重要的作用.
- 最初的诊断成像方法可能并不总是为CBD扩张提供确的结果.
研究的目的:
- 评估EUS在识别CBD扩张方面的诊断性能.
- 在初始成像研究 (超声波,CT,MRCP) 呈阴性结果的情况下,评估EUS的实用性.
主要方法:
- 追溯队列研究,包括109名患有无法解释的CBD扩张 (胆囊切除术后≥7毫米或≥10毫米) 的患者.
- 患者接受了阴性超声波 (US),计算机断层扫描 (CT) 和/或磁共振胆血管脑图 (MRCP) 后的EUS.
主要成果:
- 在41名患者中,EUS确定了病理,包括胆固醇胆病 (30.3%),慢性胰腺炎 (5.5%) 和囊癌 (1.8%).
- 负的EUS结果在1年的随访中得到证实.
- 与阳性EUS相关的因素包括老年,黄,胆病和肝脏生物化学变化.
- 在无症状患者中,肝检测正常,US (≥10毫米) 和CT (≥11毫米) 上的特定CBD直径预测了阳性EUS.
结论:
- 在诊断无法解释的CBD扩张时,EUS是一个有价值的工具,即使在MRCP阴性后也是如此.
- 在老年患者中,EUS特别有益,这些患者有诸如腹痛,黄,胆病或肝脏生物化学变化的症状.
- 腹部成像测量 (US/CT直径) 在没有异常肝检测的无症状个体中为EUS发现提供了适度的预测价值.
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