1、造影增强内镜超声在胰腺疾病诊治中的作用孙金山造影增强超声的发展 静脉造影剂最早用于心血管疾病超声检查，以增强心腔及大血管的超声显像 Keller MW, Feinstein SB, Watson DD. Successful left ventricular opacification following peripheral venous injection of sonicated contrast agent: an experimental evaluation. Am Heart J 1987; 114: 570-575 此后，该项技术在经腹超声及内镜超声领域快速发展 Goldber
2、g BB, Hilpert PL, Burns PN, Liu JB, Newman LM, Merton DA, Witlin LA. Hepatic tumors: signal enhancement at Doppler US after intravenous injection of a contrast agent. Radiology 1990; 177: 713-717 Bhutani MS, Hoffman BJ, van Velse A, Hawes RH. Contrast-enhanced endoscopic ultrasonography with galacto
3、se microparticles: SHU508 A (Levovist). Endoscopy 1997;29:635-639静脉造影剂的类型及组成胰腺疾病常规EUS的优势与不足优势 更接近病变，能够更好地显示病变的组织结构及病变与周围脏器和血管的关系 经EUS-FNA获取细胞/组织/囊液 对病变的诊断、肿瘤分级/分期、术前定位等可能优于CT/MRI不足 对肿瘤血管等显示欠佳 对一些形态相近病变，如肿块型胰腺炎vs胰腺癌vs胰腺神经内分泌肿瘤、多种胰腺囊性病变等，诊断及良恶性鉴别存在困难CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌（PDAC）的鉴别D Becker,et al.
4、Gastrointest Endosc,2001CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌（PDAC）的鉴别D Becker,et al. Gastrointest Endosc,2001CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌（PDAC）的鉴别Gheonea et al. BMC Gastroenterology，2013CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌（PDAC）的鉴别Gheonea et al. BMC Gastroenterology，2013CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌（PDAC）的鉴别Gheonea et a
5、l. BMC Gastroenterology，2013CE-EUS在胰腺疾病诊治中的应用肿块型胰腺炎与胰腺癌的鉴别Results：sensitivity and specificity of low MI contrast enhanced EUS using TIC analysis were 93.75% (95% CI = 77.77-98.91%) and 89.47% (95% CI = 65.46-98.15%), respectively. The positive predictive value of TIC analysis was 93.75% (95% CI = 77.78-98.91%) and the negative predictive value was 89.47% (95% CI = 65.46-98.15%). Gheonea et al. BMC Gastroenterology，2013
