Imaging diagnosis of autoimmune pancreatitis using endoscopic ultrasonography.

Szczegóły
Abstrakt

Tytuł:: Imaging diagnosis of autoimmune pancreatitis using endoscopic ultrasonography.
Autorzy:: Ishikawa T; Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan. .
Kawashima H; Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
Ohno E; Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Mizutani Y; Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Fujishiro M; Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
Źródło:: Journal of medical ultrasonics (2001) [J Med Ultrason (2001)] 2021 Oct; Vol. 48 (4), pp. 543-553. Date of Electronic Publication: 2021 Oct 20.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Original Publication: Tokyo, Japan : Springer Verlag, c2001-
MeSH Terms:: Autoimmune Diseases*/diagnostic imaging
Autoimmune Pancreatitis*
Elasticity Imaging Techniques*
Pancreatic Neoplasms*/diagnosis
Pancreatitis*/diagnostic imaging
Diagnosis, Differential ; Endosonography ; Humans
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Contributed Indexing:: Keywords: Autoimmune pancreatitis; Contrast-enhanced endoscopic ultrasonography; Elastography; Endoscopic ultrasonography; Imaging diagnosis
Entry Date(s):: Date Created: 20211020 Date Completed: 20211125 Latest Revision: 20211125
Update Code:: 20240105
DOI:: 10.1007/s10396-021-01143-w
PMID:: 34669071
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The diagnosis of autoimmune pancreatitis (AIP) is challenging and should be achieved through the comprehensive evaluation of clinical, radiological, serological, and pathological evidence, as there is currently no single reliable diagnostic modality. Endoscopic ultrasonography (EUS) can reveal pancreatic parenchymal and ductal features in much more detail than any other existing imaging modality. In this article, we focused on three applications of EUS, i.e., conventional EUS imaging, EUS elastography (EUS-EG), and contrast-enhanced harmonic EUS (CEH-EUS), for the diagnosis of AIP. Diffuse hypoechoic areas, diffuse enlargement, bile duct wall thickening, and peripancreatic hypoechoic margins on conventional EUS are characteristic features of AIP, and the frequencies of these findings are significantly higher in AIP than in pancreatic cancer (PC). EUS-EG of the pancreatic parenchyma in AIP showed homogenous stiffness and that the elasticity of the pancreas may change after steroid therapy. CEH-EUS revealed focal or diffuse iso-enhancement in most AIP cases and hypo-enhancement in most PC cases. However, some AIP cases show a contrast enhancement pattern similar to that of PC. It should be noted that EUS findings of AIP may differ depending on its stage or disease activity. Differentiation from PC has become an increasingly important issue in the process of diagnosing AIP, and EUS, including elastography and contrast enhancement, could be a promising imaging modality for this purpose.
(© 2021. The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine.)

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