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中华肝脏外科手术学电子杂志 ›› 2023, Vol. 12 ›› Issue (06) : 646 -650. doi: 10.3877/cma.j.issn.2095-3232.2023.06.011

临床研究

术中胰腺超声弹性成像在胰腺质地评估中的应用
杨天池, 韩威(), 邱枫, 祁佳慧   
  1. 101100 首都医科大学附属北京潞河医院普通外科
  • 收稿日期:2023-09-04 出版日期:2023-12-10
  • 通信作者: 韩威

Evaluation of pancreatic texture by intraoperative ultrasonic elastography

Tianchi Yang, Wei Han(), Feng Qiu, Jiahui Qi   

  1. Department of General Surgery, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing 101100, China
  • Received:2023-09-04 Published:2023-12-10
  • Corresponding author: Wei Han
引用本文:

杨天池, 韩威, 邱枫, 祁佳慧. 术中胰腺超声弹性成像在胰腺质地评估中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 646-650.

Tianchi Yang, Wei Han, Feng Qiu, Jiahui Qi. Evaluation of pancreatic texture by intraoperative ultrasonic elastography[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 646-650.

目的

探讨术中胰腺超声弹性成像在胰腺质地评估中的应用价值。

方法

回顾性分析2019年9月至2020年7在首都医科大学附属北京潞河医院行术中胰腺剪切波弹性成像(SWE)检查的19例患者临床资料。患者均签署知情同意书,符合医学伦理学规定。其中男8例,女11例;年龄58~76岁,中位年龄66岁。根据原发病不同分为壶腹周围肿瘤组(10例)和对照组(9例)。术中超声检测患者胰颈部SWE杨氏模量值,探索胰腺SWE杨氏模量值范围;分析术中胰腺SWE杨氏模量值与术前胰腺CT值的相关性。相关性分析采用Spearman相关。

结果

患者术中胰腺SWE杨氏模量值的中位数为13.4(11.5,17.7)kPa,其中壶腹周围肿瘤组为16.0(11.4,19.2)kPa,对照组为13.2(11.5,15.6)kPa,差异无统计学意义(Z=-0.164,P=0.905)。术前胰腺平扫CT值为34±12,术中胰腺SWE值与平扫CT值呈负相关(rs=-0.555,P=0.014)。

结论

术中胰腺SWE杨氏模量值可尝试作为量化胰腺质地的指标,初步判断胰腺质地。

Objective

To evaluate the application value of intraoperative ultrasonic elastography in the evaluation of pancreatic texture.

Methods

Clinical data of 19 patients who underwent intraoperative shear-wave elastography (SWE) examination in Beijing Luhe Hospital Affiliated to Capital Medical University from September 2019 to July 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 8 patients were male and 11 female, aged from 58 to 76 years, with a median age of 66 years. According to different primary diseases, all patients were divided into periampullary tumor group (n=10) and control group (n=9). Young's modulus of the pancreatic neck by SWE was detected by intraoperative ultrasound, and the range of Young's modulus of pancreatic SWE was investigated. The correlation between intraoperative Young's modulus of pancreas by SWE and preoperative pancreatic CT value was analyzed. Correlation analysis was performed by Spearman's correlation analysis.

Results

The median value of intraoperative Young's modulus of pancreatic SWE was 13.4(11.5, 17.7) kPa, including 16.0(11.4, 19.2) kPa in the periampullary tumor group and 13.2(11.5, 15.6) kPa in the control group. The difference was not statistically significant (Z=-0.164, P=0.905). Preoperative plain CT scan value of the pancreas was 34±12, and intraoperative SWE value of the pancreas was negatively correlated with plain scan CT value (rs=-0.555, P=0.014).

Conclusions

Intraoperative Young's modulus of the pancreas by SWE can be utilized as an index to quantify and preliminarily assess the texture of pancreas.

图1 术中超声测量胰颈部剪切波弹性成像杨氏模量值注:a示探头"压迫"胰腺;b示探头接触胰腺
表1 壶腹周围肿瘤组和对照组患者术中胰腺硬度检测及一般资料比较
图2 术中弹性成像结果与胰腺平扫CT值的相关性分析注:SWE为剪切波弹性成像杨氏模量值
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