十二指肠副乳头的超声内镜诊断

Endoscopic Ultrasonography in diagnosis of duodenal accessory nipple

摘要:

探讨内镜超声检查术（EUS）对十二指肠副乳头的诊断价值。方法 对我院内镜中心2006年2月28日至2018年2月28日期间通过EUS检查诊断为十二指肠副乳头的122例病例进行分析总结。结果 122例十二指肠副乳头病例年龄（52.1±12.9）岁，男性多于女性。副乳头以十二指肠降部乳头上方最多见（88/122，72.13%），其次位于球降交界（29/122，23.77%），少部分位于球部（5/122，4.10%）。副乳头均为单发，大多数直径在0.5~1.0 cm（88/122，72.13%），少部分直径大于1 cm（23/122，18.85%），也有部分直径小于0.5 cm（11/122，9.02%）。EUS下多为低回声（71/122，58.20%）或中低回声影（35/122，28.68%），回声多均匀。黏膜层光整，黏膜下层及以下表现为括约肌样结构，边界大部分清楚（121/122，99.18%），多数副乳头中央常可见特征性的裂隙样管腔结构（83/122，68.03%），周边肠壁层次结构正常，肠周无相关肿大淋巴结。结论 EUS能清晰显示十二指肠副乳头及相邻器官结构， EUS对十二指肠副乳头诊断具有较高的应用价值。

Abstract:

Objective To explore the diagnostic value of endoscopic ultrasonography (EUS) for duodenal accessory papilla. Methods Data of 122 cases of duodenal accessory papilla diagnosed by EUS at the endoscopy center of the First Affiliated Hospital of, Zhejiang University School of Medicine from February 28, 2006 to February 28, 2018 were analyzed and summarized. Results Of the 122 duodenal accessory papilla cases, the age was 52.1±12.9 years old, with more males than females. The most common site of duodenal accessory papillae was the descending part above the papilla (88/122, 72.13%), followed by the junction of duodenal bulb and descending part (29/122, 23.77%), and a small proportion of lesions located in the duodenal bulb (5/122, 4.10%). Duodenal accessory papillae were all solitary, whose diameter mostly ranged 0.5-1.0 cm (88/122, 72.13%), a smaller proportion of diameter larger than 1 cm (23/122, 18.85%), and only a few with diameter less than 0.5 cm (11/122, 9.02%). Most duodenal accessory papillae were hypoechoic (71/122, 58.20%) or moderate to low echogenic (35/122, 28.68%), and the echoes were mostly homogeneous. The mucosa layer was smooth, with a sphincteroid structure in the submucosa and below. The boundary of the duodenal accessory papillae was mostly clear (121/122, 99.18%) and characteristic lacunar cavity structures were often seen in the center (83/122, 68.03%). The surrounding intestinal wall was normal and no associated enlarged lymph nodes were found around the intestine. Conclusion EUS can clearly show the structure of duodenal accessory papilla and adjacent organs, and is of high value for the diagnosis of duodenal accessory papilla.