Study Of Endoscopic Ultrasonography In The Diagnosis Of Pancreatic Cystic Neoplasms

Background and Objective:Pancreatic cystic neoplasm is a rare type of neoplasm, accounting for about10%to15%of all pancreatic cystic disease, with no specific symptoms,For clinicians, their lack of knowledge of this disease, it is easy to misdiagnosis.With the development of abdominal imaging detection technology and the gradual deepening understa-nding of pathological features of the disease, there are some new names of diseases, their clas-sification is constantly being improved. For different types of cystic neop-lasms of the need to take different approaches to treatment. From the2000WHO histological point of view, according to the characteristics of existing epithelial and epithelial cystic tum-ors of the pancreas are classified into serous cystic tumor (cystadenoma and cystadeno-carcinoma), mucinous cystic tumor (cystadenoma And cystadenocarcinoma), intraductal-papillary mucinous tumor (adenoma and adenocarcinoma), solid pseudopapillary tumor. Serous cystic neoplasms include serous cystadenoma, serous adenocarcinoma is very rare, so far only10cases, not sure there is a serous cystadenoma evolved, generally considered a benign serous cystadenoma tumors. And mucinous cystic neoplasms and intraductal papillary mucinous neoplasms (IPMN) and more with malignant or potentially malignant, and different from ordinary pancreatic cancer, cystic tumor is often a high degree of differentiation, slow development, transfer later than normal pancreatic tumors resection rate and better prognosis,5-year survival rate above50%. Thus, most scholars believe that these two diseases should take aggressive surgical treatment. If early detection, early surgical outcomes better. Therefore, preoperative diagnosis of pancreatic cystic tumors and differential diagnosis is very important. Because pancreas is located in retroperitoneum, a number of peripheral vascular structure, combined with pancreatic cystic tumor etiology and classification of the diversity, not by a considerable proportion of CT, MRI diagnosis. Since1980, the United States Di Magno, etc. gave the first report of EUS, the clinical application is more and more widespread, particularly in recent years, with the EUS (endoscopic ultrasonography, EUS) of the universal, technological advances and equipment im-prove-ments, and endoscopic ultrasonography Guided fine needle aspiration (EUS-guided fine needle aspiration, EUS-FNA) technique is widely used in clinical, so a certain proportion of pancreatic cystic tumors can be diagnosed before surgery. This study aimed to investigate the Endoscopic ultrasonography diagnosis of pancreatic cystic tumorsResearch methods1、General information22patients with pancreatic cystic tumors were treated in our hospital between May2009to March2011, patients with complete data, including6males and16females, aged between28to68, with an average age of53.1years.22cases were confirmed by surgery and pathology, six cases of serous cystadenoma, mucinous cystic neoplasms,10cases of intraductal papillary mucinous tumor in6cases. Lesions in the pancreatic head and neck in15cases, seven cases of pancreatic body and tail. Recurrent upper abdominal pain and discomfort due to hospitalization in11cases, abdominal mass was found on admission in5cases, rare symptoms of nausea, vomiting, appetite loss, weight loss, back pain. Asymptomatic and found in the examination of pancreatic cystic lesions in6patients admitted to hospital. Treatment from the onset to the shortest1week, up to10years. All patients underwent EUS and EUS-FNA examination, all patients were routinely B ultrasonic examination, routine CT examination of18,routine MRI examination of15.2、MethodPENT AX EG-3830UT electronic line endoscopic ultrasonography and Hitachi Preirus color Doppler ultrasonic diagnostic apparatus, ultrasonic frequency of5-10MHz, with color flow imaging. Needle for the Wilson Cook EUSN22G needle. EUS scanning of pancreatic, the probe is in the duodenum and stomach were water balloon filling with degassed water, observation and uncinate process, head of the pancreas, pancreatic body and tail of the pancreas. After finding suspicious lesions to determine and record its position in the pancreas, quantity, maximum diameter,imaging features and the surrounding lymph nodes. When the line EUS-FNA of suspicious lesions found in endoscopic ultrasound-guided to avoid blood vessels and other vital structures, select the most appropriate path to puncture needle puncture into the lesion, connecting the syringe to maintain a constant negative pressure negative pressure under ultrasound lesions observed in the repeated needle puncture in several times. Article obtained from formaldehyde fixed tissue evacuation pathological examination, tissue fluid and conventional biochemical1tests sent to smear, and sprayed with95%ethanol fixed for cytological examination.3、Statistical analysis:By SPSS313.0statistical software, using Chi-square test, P<0.05was considered statistically significant.Results:EUS and EUS-FNA diagnosis of pancreatic cystic tumors overall accuracy was81.8%, significantly higher than that of B-18.1%, CT27.7%and MRI66.6%diagnostic accuracy. Statistical analysis using chi-square test, P=0.004, P<0.05was statistically significant. Conclusion:The diagnostic rate of EUS and EUS-FNA on pancreatic cystic neoplasm was significantly higher than B ultrasound, CT and MRI.