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| EUS、CT与磁共振成像模式在胰腺囊肿大小测量中的变异性 |
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| Variability in measurements of pancreatic cyst size among EUS, CT, and magnetic resonance imaging modalities |
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| Maimone S, Agrawal D, Pollack MJ 2010/9/13 17:35:34 |
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| Gastrointest Endosc, 2010, |
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| View at Publisher |
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Background:
Cyst size is an important factor in the management of pancreatic cysts, both in predicting the need for surgery and the frequency of follow-up.
Objective:
To determine agreement and precision of EUS, CT, and magnetic resonance imaging (MRI) modalities in the evaluation of pancreatic cyst diameter.
Design:
Retrospective chart review.
Setting:
Tertiary-care center, January 2000 to June 2009.
Patients:
This study involved 175 patients presenting for EUS evaluation of pancreatic cysts, with size measured by at least two of the aforementioned imaging studies within a 90-day period.
Main Outcome Measurements:
Largest cyst diameter from EUS, CT, MRI/MRCP, and surgical pathology.
Results:
A total of 175 patients underwent EUS. Seventy-three had CT plus EUS, 33 had MRI/MRCP plus EUS, 23 had MRI/MRCP plus CT, and 15 had all imaging studies, occurring within 90days of each other. Median size differences between studies: EUS and CT (ie, absolute value of size determined by EUS minus size determined by CT)=4mm (range 0-25mm), EUS and MRI=4mm (range 0-17mm), CT and MRI=3mm (range 2-20mm). Median size differences for surgical pathology specimens compared with results of 12 EUS, 13 CT, and 8 MRI/MRCP studies were as follows: EUS and pathology=9.5mm (range 0-20mm), CT and pathology=5mm (range 0-21mm), MRI and pathology=5.5mm (range 2-44mm).
Limitations:
Interobserver variability and small sample of surgical pathology cysts.
Conclusion:
There is considerable variation in size estimates of pancreatic cysts by different imaging modalities, which practitioners should take into account when making management decisions. Use of a single imaging modality is recommended during follow-up. The precision of imaging studies for measuring pancreatic cysts must be prospectively defined if change in size is to be reliably used for clinical management. |
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 疾病资源中心
病例分析 [栏目介绍]
王燕燕 王曙
上海交通大学附属瑞金医院内分泌科
患者，女，69岁。2009年1月无明显诱因下出现乏力，当时程度较轻，未予以重视。2009年3月患者乏力症状加重，尿色逐渐加深，大便习惯改变，颜色变淡。4月18日入我院感染科治疗，诉轻度头晕、心慌，体重减轻10kg。无肝区疼痛，无发热，无腹痛、腹泻、腹胀、里急后重，无恶性、呕吐等。入院半月前于外院就诊，查肝功能：ALT 601IU/L，AST 785IU/L，TBIL 97.7umol/L，白蛋白 41g/L，甲状腺功能：游离T3 30.6pmol/L，游离T4 51.9pmol/L，心电图示快速房颤。
医学数据库
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