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目的 探讨术中超声在胰岛素瘤定位诊断中的价值。方法 对 2 8例胰岛素瘤患者的术前B超、CT、MRI和选择性动脉造影检查的定位资料进行分析 ,统计了术中超声与术中扪诊、术中脾门静脉穿刺置管分段取血快速胰岛素测定 (PVS) 3种方法对胰岛素瘤的定位准确率 ,并进行了比较研究。结果 超声、CT、MRI和血管造影对胰岛素瘤的术前定位准确率分别为 2 8.6 % ,32 .2 % ,41 .7%和 5 0 .0 % ,而术中超声、术中扪诊和术中PVS的定位准确率分别为 92 .3%、82 .1 %和 92 .3%。结论 术中超声不但对胰岛素瘤的定位准确率高 ,而且可以清楚显示肿瘤与周围重要结构如主胰管、胆总管及血管的关系 ,帮助外科医生选择手术方式 ,降低术后并发症。
Objective To investigate the value of intraoperative ultrasound in the localization of insulinoma. Methods The preoperative ultrasound, CT, MRI and selective angiography of 28 patients with insulinoma were analyzed. The intraoperative ultrasound and intraoperative percussion, intraoperative splenic vein puncture and catheter placement were analyzed. The rapid accuracy of blood insulin determination (PVS) 3 methods for the localization accuracy of insulinoma, and a comparative study. Results The accuracy of preoperative localization of insulinoma by ultrasound, CT, MRI, and angiography was 28.6 %, 32.2 %, 41.7%, and 50.0%, respectively, while intraoperative ultrasound, intraoperative percussion and The accuracy of PVS positioning during surgery was 92.3%, 82.1%, and 92.3%, respectively. Conclusions Intraoperative ultrasound not only has high accuracy in localization of insulinoma, but also can clearly show the relationship between the tumor and the surrounding important structures such as the main pancreatic duct, common bile duct, and blood vessels. It helps surgeons to select surgical methods and reduce postoperative complications.