AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-...AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-Doppler mode under the conditions of the 2^nd harmonic imaging （with intravenous injection of 4 g Levovist） was used for echo-enhanced sonography. RESULTS： Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. ＂Young pseudocysts＂ were frequently found to have a highly vascularised wall. However, the wall of the ＂old pseudocysts＂ was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echoenhanced sonography in the differentiation of cystic pancreatic masses were 〉 90%. CONCLUSION： Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.展开更多
胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道...胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道以来,已逐渐应用到临床,其前景十分广阔.目前国内外报道 MRCP 成象序列主要是快速自旋回波序列(fast展开更多
AIM: To investigate the diagnostic ability of single-shot echo-planar imaging(EPI) diffusion-weighted imaging (DWI) to differentiate between malignant and benign pancreatic lesions. METHODS: A computerized search was ...AIM: To investigate the diagnostic ability of single-shot echo-planar imaging(EPI) diffusion-weighted imaging (DWI) to differentiate between malignant and benign pancreatic lesions. METHODS: A computerized search was performed on Pub Med, MEDLINE and EMBASE up to August 2014. Nine studies(10 sets of data) with a total of 304 malignant pancreatic lesions and 188 benign pancreatic lesions were included. The characteristics of each study included the study name, year of publication, magnetic resonance modalities used, patient population, strength of field, pulse time, repetition time, echo time(TE), maximum b factor, mean age, mean body weight, fat suppression, number of benign and malignant lesions, and true positive, true negative, false positive and false negative results. All analyses were performed using Meta-Di Sc and Stata 11.0.RESULTS: The pooled sensitivity and specificity of singleshot EPI DWI were 0.83(95%CI: 0.79-0.87) and 0.77(95%CI: 0.70-0.83), respectively. The positive likelihood ratio and negative likelihood ratio were 5.09(95%CI: 2.19-11.84) and 0.23(95%CI: 0.15-0.36), respectively. The P value for the χ2 heterogeneity for all pooled estimates was < 0.05. From the fitted summary receiver operating characteristic curve, the area under the curve and Q* index were 0.89 and 0.82, respectively. Publication bias was not present(t = 0.58, P = 0.58). Meta-regression analysis indicated that fat suppression, mean age, TE, and maximum b factor were not sources of heterogeneity(all P > 0.05). CONCLUSION: Single-shot EPI DWI is useful to differentiate between malignant and benign pancreatic lesions. Lesion size ≥ 2 cm is the limit for the diagnosis of early lesions.展开更多
文摘AIM： To describe and discuss echo-enhanced sonography in the differential diagnosis of cystic pancreatic lesions. METHODS： The pulse inversion technique （with intravenous injection of 2.4 mL SonoVue） or the power-Doppler mode under the conditions of the 2^nd harmonic imaging （with intravenous injection of 4 g Levovist） was used for echo-enhanced sonography. RESULTS： Cystadenomas frequently showed many vessels along fibrotic strands. On the other hand, cystadenocarcinomas were poorly and chaotically vascularized. ＂Young pseudocysts＂ were frequently found to have a highly vascularised wall. However, the wall of the ＂old pseudocysts＂ was poorly vascularized. Data from prospective studies demonstrated that based on these imaging criteria the sensitivities and specificities of echoenhanced sonography in the differentiation of cystic pancreatic masses were 〉 90%. CONCLUSION： Cystic pancreatic masses have a different vascularization pattern at echo-enhanced sonography. These characteristics are useful for their differential diagnosis, but histology is still the gold standard.
文摘胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道以来,已逐渐应用到临床,其前景十分广阔.目前国内外报道 MRCP 成象序列主要是快速自旋回波序列(fast
基金Supported by Key Program of Scientific Research of Fujian Medical University,FMU 09ZD014
文摘AIM: To investigate the diagnostic ability of single-shot echo-planar imaging(EPI) diffusion-weighted imaging (DWI) to differentiate between malignant and benign pancreatic lesions. METHODS: A computerized search was performed on Pub Med, MEDLINE and EMBASE up to August 2014. Nine studies(10 sets of data) with a total of 304 malignant pancreatic lesions and 188 benign pancreatic lesions were included. The characteristics of each study included the study name, year of publication, magnetic resonance modalities used, patient population, strength of field, pulse time, repetition time, echo time(TE), maximum b factor, mean age, mean body weight, fat suppression, number of benign and malignant lesions, and true positive, true negative, false positive and false negative results. All analyses were performed using Meta-Di Sc and Stata 11.0.RESULTS: The pooled sensitivity and specificity of singleshot EPI DWI were 0.83(95%CI: 0.79-0.87) and 0.77(95%CI: 0.70-0.83), respectively. The positive likelihood ratio and negative likelihood ratio were 5.09(95%CI: 2.19-11.84) and 0.23(95%CI: 0.15-0.36), respectively. The P value for the χ2 heterogeneity for all pooled estimates was < 0.05. From the fitted summary receiver operating characteristic curve, the area under the curve and Q* index were 0.89 and 0.82, respectively. Publication bias was not present(t = 0.58, P = 0.58). Meta-regression analysis indicated that fat suppression, mean age, TE, and maximum b factor were not sources of heterogeneity(all P > 0.05). CONCLUSION: Single-shot EPI DWI is useful to differentiate between malignant and benign pancreatic lesions. Lesion size ≥ 2 cm is the limit for the diagnosis of early lesions.
