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目的 探讨彩色内镜超声在胰岛细胞瘤术前定位诊断中的作用。方法 对经内科检查定性诊断为胰岛细胞瘤,并准备手术切除的 7例患者,术前进行彩色多普勒内镜超声（ECDUS）、经腹B超和胰腺螺旋CT增强扫描检查,并与手术和病理检查结果相对照,比较上述3种影像学检查在术前定位诊断中的作用。结果7例患者手术和病理检查共发现10个病灶,ECDUS检出8个,胰腺螺旋CT增强扫描检出1个,经腹B超未有检出,病灶部位与手术所见一致。ECDUS漏诊的2个病灶,直径均小于或等于0.5cm。检查中无并发症发生。结论 ECDUS对胰岛细胞瘤的术前定位诊断比B超、CT等无创性检查技术,敏感性高,定位准确,但对于直径小于或等于0.5cm的病灶,定位诊断仍有困难。
Objective To investigate the role of color endoscopy in the preoperative localization of islet cell tumors. Methods Seven patients diagnosed as insulinoma by internal medicine examination and prepared for surgical resection were examined with ECDUS, abdominal ultrasonography and pancreatic helical CT before operation. Compared with the results of pathological examination, the above three kinds of imaging examination in the role of preoperative localization diagnosis. Results A total of 10 lesions were detected by surgery and pathological examination in 7 patients, 8 by ECDUS, 1 by spiral CT scan, and undetectable by abdominal B-ultrasound. The site of the lesion was consistent with the surgical findings. ECDUS missed two lesions, diameter less than or equal to 0.5cm. No complications during the examination. Conclusion ECDUS has a higher sensitivity and accurate positioning for non-invasive diagnosis of islet cell tumor than non-invasive ultrasound such as B-mode ultrasonography and CT. However, the diagnosis of islet cell lesion with diameter less than or equal to 0.5cm still remains difficult to diagnose.