Significance of normal appearance on endoscopic ultrasonography in the diagnosis of early chronic pancreatitis

被引:9
|
作者
Sato, Ai [1 ]
Irisawa, Atsushi [1 ]
Bhutani, Manoop S. [3 ]
Shibukawa, Goro [1 ]
Yamabe, Akane [1 ]
Fujisawa, Mariko [1 ]
Igarashi, Ryo [1 ]
Arakawa, Noriyuki [1 ]
Yoshida, Yoshitsugu [1 ]
Abe, Yoko [1 ]
Maki, Takumi [1 ]
Hoshi, Koki [1 ]
Ohira, Hiromasa [2 ]
机构
[1] Fukushima Med Univ, Aizu Med Ctr, Dept Gastroenterol, 21-2 Maeda, Aizu Wakamatsu, Fukushima 9693492, Japan
[2] Fukushima Med Univ, Sch Med, Dept Gastroenterol & Rheumatol, 1 Hikarigaoka, Fukushima, Japan
[3] Univ Texas Houston, MD Anderson Canc Ctr, Dept Gastroenterol Hepatol & Nutr, Unit 1466, 1515 Holcombe Blvd, Houston, TX 77030 USA
关键词
Chronic pancreatitis; early stage; endoscopic ultrasonography; RETROGRADE CHOLANGIOPANCREATOGRAPHY; ULTRASOUND; EUS; PANCREATOGRAPHY; AGREEMENT; HISTOLOGY; SEVERITY;
D O I
10.4103/2303-9027.209870
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Objectives: The Rosemont classification (RC) was developed as a consensus-based standard for the diagnosis of chronic pancreatitis (CP) by endoscopic ultrasonography (EUS), however, it is more complicated than the conventional scoring system. We have noticed that in the early stages of CP, it is not unusual to observe pancreas with abnormal appearance coexisting with the areas of normal parenchyma. The aim of this study was to investigate the validity of a "normal" pancreas appearance and to evaluate the usefulness of modified diagnostic criteria in comparison to the traditional EUS criteria and the RC. Patients and Methods: One hundred and seventy-seven patients who had undergone both EUS and endoscopic retrograde pancreatography (ERP) within 2 months were enrolled in the study, and patients with pancreatic cancer were excluded from the study. ERP findings were used as the gold standard for the diagnosis of CP. The EUS images obtained were classified according to both the RC and our new modified criteria. The latter includes an additional criterion to the modified traditional criteria: fine-reticular pattern (F-RP) was defined as a normal pancreatic parenchyma. We compared the accuracy between the new modified EUS criteria and the RC. Results: (1) Normal or equivocal findings on ERP were obtained for 132 patients; 113 patients had F-RP on EUS. In contrast, F-RP was found in only 6 out of 45 CP cases on ERP (P < 0.0001). (2) We investigated the diagnostic capability of our new criteria for endoscopic retrograde cholangiopancreatography normal/equivocal pancreas compared to the traditional criteria. In cases where fewer than two points were defined as normal, the incidence of normal pancreas was significantly higher based on the new criteria than on the traditional criteria (P = 0.002). (3) No significant differences were found between the new criteria and the RC across all ERP grades. Conclusion: Our new proposed "normal-added EUS criteria" for diagnosing CP was equivalent to the RC.
引用
收藏
页码:110 / 118
页数:9
相关论文
共 50 条
  • [1] Endoscopic ultrasonography in the diagnosis of chronic pancreatitis
    Barthet, M.
    Heyries, L.
    [J]. ACTA ENDOSCOPICA, 2009, 39 (05) : 337 - 344
  • [2] Endoscopic Ultrasonography for the Diagnosis of Chronic Pancreatitis
    Mainie, Inder
    Vaughan, Rhys
    Faias, Sandra
    Mann, Moss
    Romagnuolo, Joseph
    Hoffman, Brenda
    Hawes, Robert
    [J]. GASTROINTESTINAL ENDOSCOPY, 2006, 63 (05) : AB278 - AB278
  • [3] ENDOSCOPIC ULTRASONOGRAPHY IN THE DIAGNOSIS OF CHRONIC-PANCREATITIS
    ZUCCARO, G
    SIVAK, MV
    [J]. ENDOSCOPY, 1992, 24 : 347 - 349
  • [4] Usefulness of endoscopic ultrasonography for the diagnosis of chronic pancreatitis
    Hiroyuki Miyakawa
    Tosihiro Suga
    Keiya Okamura
    [J]. Journal of Gastroenterology, 2007, 42 : 85 - 89
  • [5] Usefulness of endoscopic ultrasonography for the diagnosis of chronic pancreatitis
    Miyakawa, Hiroyuki
    Suga, Tosihiro
    Okamura, Keiya
    [J]. JOURNAL OF GASTROENTEROLOGY, 2007, 42 (Suppl 17) : 85 - 89
  • [6] Diagnosing Early Chronic Pancreatitis by Endoscopic Ultrasonography
    Miyakawa, Hiroyuki
    Okamura, Keiya
    Nagakawa, Tatsuya
    Hirayama, Atsushi
    Matsunga, Takahiro
    Oku, Daiki
    [J]. PANCREAS, 2010, 39 (05) : 701 - 702
  • [7] A Comparative Study of Endoscopic Ultrasonography and Histopathology Images for the Diagnosis of Early Chronic Pancreatitis
    Sekine, Masanari
    Tanaka, Akira
    Akimoto, Maho
    Miura, Takaya
    Fujiwara, Junichi
    Noda, Hiroshi
    Rikiyama, Toshiki
    Ohnishi, Hirohide
    Mashima, Hirosato
    [J]. PANCREAS, 2021, 50 (08) : 1173 - 1179
  • [8] Ascaris pancreatitis: Early diagnosis by ultrasonography and endoscopic treatment
    Yamamoto, H
    Tamada, K
    Tomiyama, T
    Ido, K
    Kimura, K
    [J]. ENDOSCOPY, 1998, 30 (03) : 316 - 316
  • [9] Endoscopic Ultrasonography Findings of Early and Suspected Early Chronic Pancreatitis
    Takasaki, Yusuke
    Ishii, Shigeto
    Fujisawa, Toshio
    Ushio, Mako
    Takahashi, Sho
    Yamagata, Wataru
    Ito, Koichi
    Suzuki, Akinori
    Ochiai, Kazushige
    Tomishima, Ko
    Saito, Hiroaki
    Isayama, Hiroyuki
    [J]. DIAGNOSTICS, 2020, 10 (12)
  • [10] THE DIAGNOSIS OF CHRONIC-PANCREATITIS AND PANCREATIC-CANCER BY ENDOSCOPIC ULTRASONOGRAPHY
    NOGUCHI, T
    AIBE, T
    AMANO, H
    FUJI, T
    TAKEMOTO, T
    [J]. DIGESTIVE DISEASES AND SCIENCES, 1986, 31 (10) : S62 - S62