Chronic pancreatitis (CP) is a progressive condition that is associated with severe complications. Diagnosis of late CP is easy due to characteristic clinical presentation and pathognomonic imaging findings, such as pancreatic calcifications. Early changes, such as lobularity and a dilated main pancreatic duct, are very subtle and challenging to detect with ultrasonography (US) or even computed tomography (CT). Data were accumulating on the usefulness of EUS in the early diagnosis of CP. The sensitivity values for detecting early CP (ECP) by US, MRI, and EUS were 67–69%, 77–78%, and 81–84%, respectively. The specificity values for detecting ECP by US, MRI, and EUS were 90–98%, 83–96%, and 90–100%, respectively. Pancreatic cancer (PDAC) is one of the leading cancers worldwide, with increasing morbidity. Due to its poor prognosis and survival, early diagnosis is crucial. For this indication, EUS also shows better outcomes compared to other imaging methods, especially in tumors < 2 cm. The sensitivity and specificity for diagnosing PDAC with MRI and EUS were 52.3–93%, 77.1–89%, 72–100%, and 90%, respectively. In addition, EUS can detect precancerous conditions that are associated with a higher risk of PDAC. EUS-assisted new techniques, like elastography and contrast enhancement, facilitate the diagnosis of pancreatic lesions and make it even more accurate. Early PDAC changes, such as main pancreatic duct dilatation or irregular margins of pancreatic solid masses, may be detected with EUS. This review describes the efficacy of different imaging techniques in the early detection of CP and PDAC. In addition, we describe the useful interventions made possible by early diagnosis of PDAC and CP.
慢性胰腺炎是一种进行性疾病，常伴随严重并发症。晚期慢性胰腺炎因具有特征性临床表现及特异性影像学表现（如胰腺钙化）而易于诊断。早期病变如胰腺小叶化、主胰管扩张等征象极为隐匿，即使采用超声或计算机断层扫描也难以准确识别。近年来，内镜超声在慢性胰腺炎早期诊断中的应用价值日益凸显。超声、磁共振及内镜超声对早期慢性胰腺炎的检测灵敏度分别为67-69%、77-78%及81-84%，特异性分别为90-98%、83-96%及90-100%。 胰腺导管腺癌是全球主要恶性肿瘤之一，发病率持续上升。因其预后不良、生存率低，早期诊断至关重要。在此适应症中，内镜超声相较于其他影像学方法展现出更优的诊断效能，尤其对直径小于2厘米的肿瘤。磁共振与内镜超声诊断胰腺导管腺癌的灵敏度分别为52.3-93%与72-100%，特异性分别为77.1-89%与90%。此外，内镜超声可识别与胰腺导管腺癌高风险相关的癌前病变。内镜超声辅助新技术如弹性成像与造影增强，显著提升了胰腺病灶的诊断效能与准确性。内镜超声可检测胰腺导管腺癌早期征象，如主胰管扩张或胰腺实性肿块边缘不规则等。 本综述系统阐述了不同影像学技术在慢性胰腺炎与胰腺导管腺癌早期诊断中的效能，并探讨了通过早期诊断实现的有效干预措施。
肿瘤(癌症)患者之家